Minnesota Attorney General's Office
1400 Bremer Tower
445 Minnesota Street
St. Paul, MN 55101
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Legal Alert of The Month
Nursing Home Assisted Living
With the aging population, more Minnesotans will find themselves seeking nursing home or assisted living residence for themselves or a loved one in the coming years. Minnesota Attorney General Lori Swanson provides the following information on how to research finding the right place for your loved one.
Nursing Homes vs. Assisted Living Residences. Nursing homes and assisted living residences differ in terms of the medical care and services they provide. A nursing home is a facility that provides nursing care to people who are not sick enough to need hospital care but who are not able to remain at home. An “assisted living” facility generally combines housing, support services, and some kind of health care. Individuals who choose assisted living can customize the services they receive to meet their individual needs. To be considered an assisted living residence, the facility must provide or make available, at a minimum, specified health-related and supportive services. Examples include: assistance with selfadministration of medication or administration of medication, supervised by a registered nurse; two meals daily; daily check system; weekly housekeeping and laundry services; assistance with three or more activities of daily living (dressing, grooming, bathing, eating, transferring, continence care, and toileting); and assistance in arranging transportation and accessing community and social resources.
Review Surveys and Report Cards. Every nursing home and assisted living facility in Minnesota must have a state license from the Minnesota Department of Health (“MDH”) in order to operate. MDH conducts “surveys” of nursing homes and assisted living facilities to check whether they are in compliance with state and federal rules. Survey results can be obtained by contacting MDH at (651) 201-4201 or 1-800-369-7994, or online at: www.health.state.mn.us/divs/fpc/directory/surveyfindings.htm (for nursing homes) or www.health.state.mn.us/divs/fpc/profinfo/cms/ als/alsreviewresults.html (for assisted living).
MDH and the Minnesota Department of Human Services also jointly created a nursing home “report card.” Nursing home report cards can be obtained on-line at: www.health.state.mn.us/nhreportcard or by telephone at: 1-800-333-2433. The report card allows consumers to compare nursing homes on seven quality measures: (1) Resident satisfaction and quality of life; (2) Quality indicators—clinical quality; (3) Hours of direct care; (4) Staff retention; (5) Use of temporary nursing staff; (6) Proportion of beds in single bedrooms; and (7) State inspection results. A nursing home can receive one star to five stars on each measure. Consumers can search nursing homes by area of the state and the three measures most important to them. Although helpful, the report card alone should not be the only information used when choosing a nursing home.
To find out whether a given nursing home or assisted living facility is Medicare or Medical Assistance (“MA”) certified, whether regulatory action has been taken against it, what level of care is offered, or what its bed capacity is, contact MDH at (651) 201-4201 or 1-800-369-7994 or review its online Provider Database at: www.health.state.mn.us/divs/fpc/directory/ fpcdir.html.
Nursing Home Selection. The following is a list of questions you may want to consider before making a nursing home selection:
1. Is the nursing home Medicare or MA certified?
2. Does the nursing home have the level of care needed and is a bed available? (Check with MDH and/or ask the facility directly).
3. Is there a full-time registered nurse in the nursing home at all times?
4. What is the nursing home’s staff retention rate?
5. Does the same team of nurses and certified nursing assistants work with the same residents most days per week?
6. Is there a choice of food items at each meal, and are residents able to get their favorite food items?
7. Are staff available to help residents eat and drink during mealtimes?
8. Are there daily activities for the residents?
9. Does the facility allow pets?
10. Is there an active volunteer program?
11. What is the nursing home’s safety and care plan in the event of an emergency?
Assisted Living Selection. Each assisted living residence or facility is unique. It’s important for consumers to ask about the services, amenities, accommodations and care provided. Consumers should ask to review a copy of the residence agreement outlining services, prices, extra charges, admission and discharge criteria, staffing and residence rules. You may want to consider the following questions before making an assisted living selection:
1. Are additional services available if a resident’s needs change?
2. What are the costs of the services?
3. Are residents required to purchase renters’ insurance for personal property in their units?
4. Does the residence have a clearly stated procedure for responding to a resident’s medical emergency?
5. What are the medical services available and how are they provided?
6. Is staff available to meet scheduled and unscheduled needs?
7. Are pharmacy, barber/beautician, and physical therapy offered on-site?
8. Is transportation available for residents to go to doctor appointments, etc.?
9. Are there organized activities for residents?
10. Can residents have pets?
11. Do volunteers come into the residence to help with or conduct programs?
12. Do food menus vary from day to day and meal to meal, and are they nutritionally balanced?
13.Are staff welcoming and professional?
14. Do the residents socialize with one another?
15. Is the residence accommodating to wheelchairs and walkers?
16. Is the residence free of odors and appropriately heated/cooled?
17. Does the residence have a means of security if a resident wanders?
18. Does the residence have a process for assessing a resident’s need for services and are those needs addressed periodically?
19. Are there government, private, or corporate programs available to help cover the cost of services to the resident?
Visit the Facility. Making an unannounced visit to a nursing home or assisted living facility can be a helpful way to scope out its day-to-day function. You may wish to observe:
1. Is the facility well-kept?
2. Are the residents clean, appropriately dressed, and well-groomed?
3. Are the staff polite and respectful?
4. Do the staff recognize the residents by name?
5. Do the staffing levels appear appropriate for the number of residents?
Consumer Complaints. Every person deserves to receive quality care, respect, and dignified treatment from a nursing home or assisted living residence. If you or a loved one are concerned about the quality of care provided by a nursing home or assisted living residence, you should report your concerns to the Minnesota Department of Health.
Minnesota Department of Health
85 East Seventh Place, Suite 400
Saint Paul, MN 55101
Consumers with additional questions may contact the Office of Attorney General Lori Swanson.