Moving a Patient to a Safer Facility

So, you have a family member who currently resides in one nursing home, but you discovered that they’ve long been abused or neglected or given the facility’s apparent staffing shortages or inadequate training, uncleanliness, lack of security, or some other concerns, you fear that it’s only a matter time before a bad situation occurs. What do you do? However inconvenient it may sound and be, it may be high time to relocate your loved one to a different facility. Below, we’ll outline factors to take into account when considering moving a patient to a safer nursing home.

Planning for the Move

While relocations like these often occur with little advance notice, it doesn’t mean that you should just pick anywhere to move your relative to. Instead, you should follow these steps to ensure you make a wise choice that will be a good fit for your family member:

Making a List of Potential New Homes

You’ve already had issues at your family member’s nursing home, and now you’re planning to move them to a new one. How do you narrow down your choices? You should create a preliminary list of facilities by:

• Asking friends or relatives for recommendations
• Cross-referencing that shortlist or adding to it by reviewing online reviews of area facilities

As for the latter point, since many elderly individuals are on Medicare, using the health insurer’s Care Compare tool can be particularly helpful in finding reliable ratings for facilities. It allows you to type in a city/state combination or zip code to get overall rating information and more information about where any potential deficits lie.

Observances To Make When Visiting a New Long-Term Care Facility

Finding the right replacement nursing home to relocate your loved one to may involve you taking tours of your shortlisted facilities. When doing so, take note of the following:

• The smell in the facility: One detail to take into account is whether there is a fresh, clean scent in the air or do you smell bodily waste, like urine or feces, for example.
• What you see residents eating: Do you see them consuming a balanced, nutritious meal or old, unappetizing canned foods?
• How residents appear: You should look to see if residents appear to be generally healthy, mobile, happy, and attentive as opposed to isolated, bedridden, wheelchair bound, and unwell and if they appear to be interacting with one another.
• What the staff is doing: Does the facility appear to have enough employees for the residents? Does the staff seem to be on their phones and chatting among themselves, ignoring their patients? How do you hear employees talking to residents (respectfully and caringly or condescendingly or aggressively)? Do they appear to offer programming to boost resident morale?
• The security protocol in place: Do you see a receptionist or security guard near the entrance of the facility? Do you see surveillance cameras installed in key areas of the facility?
• Cleanliness of the rooms and facility, in general: We already mentioned potential foul odors to be on the lookout for, but taking a look at whether bathrooms, countertops, and floorboards appear to be clean, whether trash is properly disposed of, and if there are potential fall hazards like papers of boxes in hallways is important.

Questions To Ask When Determining if a Different Nursing Home Is the Right Fit

Whether you call the facility by phone or visit in person and meet with its staff, asking the following questions can help you decide if the facility you’re planning to move your relative to is indeed a safer one than their last:

• What are the nursing home’s staff-to-resident ratios
• How frequently do they check in on residents
• Whether there are any call devices whereby patients can summon help if needed
• Who plans out food menus, and what happens if a patient has special dietary needs
• Whether there are safety protocols in place to minimize wanted
• How often they change residents’ clothing or bed linens (if they’re unable to do so themselves)
• What is the sanitation protocol they use for infection control in the nursing home
• Whether there are sign-in and out procedures at the facility to ensure not just anyone comes and goes
• If there are procedures in place to minimize the chances of drug errors
• What direct caregiver hiring practices are like (i.e., whether background checks are performed, what degrees or certifications they must have, and any additional training they receive)

Asking questions like these of staff in person provides you with an opportunity to take note of the sincerity/genuineness with which the staff member is responding.

Additionally, it’s quite possible that, in visiting the facility, you may encounter talkative residents or their family members and friends, whom you can also ask questions about their experience with the facility.

Reaching Out to Transportation Providers

If your loved one is relatively mobile or they’re not, but you have a handicap-accessible vehicle, you may be able to transport them yourself from one facility to the next with a family member’s assistance.

However, if you don’t have the right type of vehicle to transport them and they’re confined to a bed or wheelchair or utilize special equipment, reaching out to different medical transport providers, some of which offer non-emergency ambulance service, may be ideal.

When contacting these companies, being clear about the nature of the transfer and your relative’s medical needs will be critical.

Preparing for the Move

Relocating your loved one takes some preparation. You’ll want to make sure the following are taken care of in the days and hours before the transfer occurs:

What the Current Nursing Home Should Do in Preparation for a Loved One’s Relocation

There are state and federal laws that protect the rights of nursing home residents, even when they’re being prepared to be relocated to a different facility. In Ohio, for example, staff at the patient’s current facility must perform “discharge planning and sufficient preparation and orientation to residents being transferred/discharged,” per the Ohio Department of Aging.

The Value of a Discharge Plan

Long-term care facilities should have transfer protocols in place, which include essentially providing discharge instructions to the residents and to the place they’re headed to. That plan should detail the following regarding that individual’s departure or relocation from the facility:

• The name and contact information for the new one that they’re headed to
• The date it is occurring
• Why it is happening
• Any information pertinent to the availability of space to re-home the patient should they want to return to their current place of residence
• Long-term care ombudsman and other regulatory agency contact details
• Any protocol that should be followed if someone wants to contest the relocation

As you can tell, there’s no mention of medical records and medication lists above. It may also be important to secure this information from a doctor to include with the discharge paperwork compiled by nursing home staff to give them a clearer picture of your loved one’s needs.

How a New Assisted Living Facility Should Prepare for a New Resident’s Arrival

Nursing homes receiving transferred patients should prepare for the impending arrival by:

• Reviewing any discharge instructions and medical records received from the previous facility
• Setting up a fall assessment for immediately after the new resident arrives
• Arranging an orientation to the facility and its policies and procedures and for a meet-and-greet with their new “neighbors”
• Making sure their room is freshly cleaned and specialized equipment, accessories, or furniture needed is present
• Coordinating the arrival procedures with the family member or transport team bringing the individual

The Role of Communication in Moves Between Nursing Homes

One key component when moving a patient to a safer nursing home is communication. This should happen at a few different stages, including:

• Sharing concerns you have about the treatment your loved one has endured with fellow family members or reporting it to the appropriate authorities if needed
• Breaking the news to your relative that their current facility is no longer a good choice for them and that they need to relocate
• Telling staff at the current facility of your plans to move your family member to another one and navigating discussions regarding why you’re doing so
• Addressing reasons behind their departure from their current nursing home and current care needs with the prospective new residence and its employees
• Facilitating conversations with staff at the new facility about any of the patient’s potential unmet needs that they may be unaware of early on
• Maintaining an open line of communication with your resident family member to ensure they feel comfortable voicing adjustment and other issues so that you can rest comfortably in knowing that the new situation is the best scenario possible

We’re hopeful that this guide along with our other resources aids you in moving a patient to a safer nursing home as seamlessly as possible under the circumstances.