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Nursing Homes and Short-Term Rehabilitation
A woman assisting an older woman whose arms are stretched out in front of her.

Nursing Homes, including short-term rehabilitation

Nursing Homes serve consumers needing more medical services than those available through home care, assisted living and other options. Nursing Homes do not necessarily mean long-term care; more than half of all nursing homes stays are for three months or less. Increasingly, nursing homes are used to complement and supplement other care options, including assisted living, hospital and home care particularly for short-term rehabilitation. The Ohio Department of Health licenses and/or certifies nursing homes and conducts on-site inspections/surveys for compliance with state and federal rules and regulations.

To determine if a nursing home is a good option for you, contact your area agency on aging and request a free assessment.

How to Select?

There are almost 1,000 nursing homes in the state of Ohio.  How do you determine which will meet your needs?  The first steps involve reviewing the possibilities to narrow your selection:

Services.  Review the services each nursing home offers for those that will meet your needs.  Each facility may indicate on the Long-Term Care Consumer Guide the special services they offer.  Does the facility's description of services match the medical, social and community connections you desire? Does the facility offer the type of therapy you need?

Location. Use the geographic search function to find nursing homes within a comfortable travel distance from friends and family.

Quality Indicators

All consumers of long-term care services deserve excellent care.  The Long-Term Care Consumer Guide contains the following information about each nursing home licensed by the State of Ohio and/or certified for Medicaid/Medicare by the federal government. All consumers of long-term care services deserve excellent care.  The Long-Term Care Consumer Guide contains the following information about each nursing home licensed by the State of Ohio and/or certified for Medicaid/Medicare by the federal government:

  • Inspection Reports, from the Ohio Department of Health, provide information on nursing home compliance with state and federal law.
  • Facility Details, such as the special services provided, the religious or fraternal affiliations, accreditation, costs, and staffing ratios, are provided by the facilities.
  • Family Satisfaction Survey Scores reflect the opinions of family members of nursing home residents at a point in time and provide clues for you when evaluating a home for yourself or your family or friend. You may view a spreadsheet of overall satisfaction scores for nursing homes.
  • Resident Satisfaction Survey Scores reflect the perceptions of nursing home and residential care (assisted living) facility residents gathered through face-to-face surveys. Spreadsheets of overall satisfaction scores for nursing homes and overall satisfaction scores for residential care facilities are available.

Review the quality information available particularly for the medical, social, spiritual and community needs you have.  A facility that scores low on clinical measures, has low satisfaction with direct care and nursing staff and is repeatedly cited for medication errors would not be an appropriate choice for a resident at risk for medical complications.  On the other hand, a facility with high satisfaction with activities and few or no citations in the areas of choice and dining areas may be a good choice for a resident who enjoys socialization and activities.

The Federal Centers for Medicare and Medicaid Services also offers Nursing Home Compare.  Nursing homes that are certified to participate in Medicare or Medicaid are rated according to a 5-star system based on inspection results, quality measures and staffing. Review the federal Centers for Medicare & Medicaid Services' "Your Guide to Choosing a Nursing Home."

Costs

Confirm with the facility staff that the nursing homes you consider will accept your insurance coverage, Medicaid or Medicare or that the rates are within your ability to pay privately.  Please review the How To Pay resource in this guide to learn about pay options for Nursing Homes including Short-Term Care and Rehabilitation.

Visit

Once you've narrowed your list of prospective nursing homes, it is very important to visit the homes you're considering.  If possible, you should visit multiple times and at different times of day to get a good sense of what the home is like on a day-to-day basis.  Speak with current residents and their families about their experiences.

Positive observations

  • The interactions between residents and staff are marked by friendliness, patience and respect. Staff seem to know the residents well, call them by name, and know what they like and don’t like. 
  • Staff knock before entering residents’ rooms and residents have privacy available to them, even in shared rooms.
  • Look for residents engaged in age-appropriate activities, able to get outside, or able to rest comfortably.
  • Meal service is appetizing and the dining room(s) are appealing.  Residents are assisted with eating, if needed.

Concerns

  • Loud overhead paging and call lights going unanswered.
  • Staff clustered around nurse’s stations without interacting with residents.  Residents grouped in front of the nurse’s station with nothing to do, slumped in wheelchairs.
  • Meals are served late, aren’t appealing, or served at the wrong temperatures.  Residents left unassisted in front of their meals or not served at the same time as their table-mates.
  • Residents dressed inappropriately for the weather or in gowns or clothing that doesn’t sufficiently cover their bodies.  Residents’ personal grooming is not dignified.
  • Poor maintenance or cleanliness in the resident and common areas.  Pervasive odors, unwashed linens.

How to Select?

  • Physical Functional Ability: inability to complete day to day activities, called activities of daily living (ADLs): bathing and personal hygiene, putting clothes on and taking them off, using the toilet and cleaning up after oneself, mobility/transferring (walking from one room to another, getting out of bed and into a chair), and eating. In addition, instrumental activities of daily living (IADLs) may also be taken into account. These activities do not necessarily need to be done on a daily basis, but are necessary to live independently: shopping for groceries and other essentials, meal preparation, housecleaning, laundry, medication management, and paying the bills.
  • Medical Care: Needing assistance with injections, catheter care, and intravenous medications.
  • Cognitive Changes: Alzheimer’s disease or a related dementia, such as dementia from Parkinson’s disease or Lewy body dementia. If one is not able to make appropriate and/or safe decisions, putting himself / herself in danger if living independently without supervision and assistance.
  • Behavioral Changes: frequent wandering from the home and becoming lost, impulsiveness, and aggressiveness (physical, sexual, verbal).

If you need further help in selecting a nursing home or are not sure it’s the right setting for you, please contact the Long-Term Care Ombudsman program serving your area. Ombudsmen link residents with services or agencies, offer advice on selecting long-term care providers, inform consumers about their rights and provide information and assistance with benefits and insurance.

What to do if you have a problem in a nursing home:

Know your rights as a long term care consumer. Please review the Residents' Rights page for information about rights regarding discharge, choice, information and privacy.

Get assistance

The Long-Term Care Ombudsman Program can help ensure residents’ complaints are investigated and resolved.  Ohio’s Office of the State Long-term Care Ombudsman advocates for people receiving home care, assisted living and nursing home care. Paid and volunteer staff work to resolve complaints about long-term care services.  Ombudsmen do not “police” nursing homes and home health agencies. Instead, they work with providers, residents, their families and other representatives to resolve problems and concerns. Ombudsmen advocate a person-centered approach to meeting the needs and honoring the preferences of their clients.