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How To Pick A R.I. Nursing Home


Many families struggle with the heart-wrenching decision of placing a loved one in a skilled-nursing facility. Once the decision has been made, here are some important factors to consider before selecting a nursing home in Rhode Island:

What Are Your Loved One’s Medical Issues?

By state and federal law, upon admittance nursing facilities must conduct an initial assessment of your loved one’s medical needs, including their functioning as to activities of daily living (“ADLs”). Before this occurs, you should understand your loved one’s medical needs. Speak with your loved one’s doctors and observe everything (some of my clients even keep a journal). Once you understand the exact medical issues, you can better evaluate and interview potential nursing homes. For example, dementia and Alzheimer’s patients have special needs that not every R.I. nursing home can adequately address. Knowing your loved one’s medical needs will help you become an active advocate for your loved one. When nursing homes make mistakes, this may help you minimize the effects of such mistakes or even prevent injury.

What should you learn about potential nursing facilities?

First and foremost, who owns and operates the facility? Many nursing homes are now owned by large corporate conglomerates that are not based in Rhode Island. Most experts urge consumers to seriously be wary of such nursing facilities, because they may overemphasize corporate profit over quality care. The R.I. Secretary of State provides ownership information here. Next, from my perspective as an R.I. personal injury lawyer including R.I. nursing home lawyer — understaffing is a major concern. Some important questions to ask are: How many staff to patients are there (“staff-patient ratio”) on a given shift? How many Resident Nurses (as opposed to Certified Nurse Assistants) are on duty each shift? Finally, access the public records and ask specific questions about past deficiencies. There are minimum standards set forth in state and federal regulations. The R.I. Department of Health maintains information here. This agency also conducts inspections and any deficiencies cited are public record.  This is important because I have handled cases as an RI nursing home lawyer where falls and elopement (wandering from the facility) were substantially caused by understaffing and/or there was a pattern of neglect. 

 What Is The Facility’s Cost And Fine Print?

Although outside my realm as an R.I. personal injury lawyer, it is a good idea to consult with a Rhode Island attorney who advises on Medicaid/Medicare issues and financing a loved one’s stay at a nursing home. That same lawyer should also be able to review the nursing home’s contract before you sign. You may be surprised at the sources of funding available ... and of the terms in the contractual fine print. 

John Walsh

9:43 am on Tuesday, April 17, 2012

Thanks for the post, Mike. Helpful information on issues that many of us are facing.

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Mike Bottaro

6:38 pm on Tuesday, April 17, 2012

John: Thanks... As a wordsmith, I was curious if the title is grammatically correct "A R.I." or should it be "An R.I."?

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John Walsh

5:37 pm on Thursday, April 19, 2012

Good question, Mike. Here's the guidance from Grammar Girl, an excellent online grammar resource (www.grammar.quickanddirtytips.com):

"The rule is that you use 'a' before words that start with a consonant sound and 'an' before words that start with a vowel sound." (The key is the sound, not the letter.)

So based on that, "An R.I." would be right (and you treated it that way in your copy – an R.I. personal injury lawyer). Probably matters more when we hear it than when we read it – don't think many read "A R.I." in your headline and had pause.

Thanks again for your post.

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John Walsh

11:57 am on Friday, April 20, 2012

Good question, Mike. Here's guidance from Grammar Girl, a good online grammar resource (http://grammar.quickanddirtytips.com/):

The rule is that you use "a" before words that start with a consonant sound and "an" before words that start with a vowel sound.

So "a Rhode Island" but "an R.I." (You did use "an R.I." in your article – "an R.I. personal injury lawyer").

Thanks again for the post.

Martha Reynolds

11:09 pm on Tuesday, April 17, 2012

This is very helpful, Mike. My mother began in an assisted-living facility that also had a dementia wing. After six months, she needed an SNF. We chose a not-for-profit, non-corporate facility. My mother received excellent care for the three years she was there; however, every family member should be very pro-active in their loved one's care. Get to know the people at the facility by name. Show up and visit! Ask questions. And be sure to thank the caregivers for what they do.

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