nursing home

Leaving the Hospital After A Fall or Injury

Often my blog ideas come straight from a new client who is frustrated and needs an advocate. Frustrated with the amount of information given to them. Often clients are needing information about leaving the hospital after an illness or injury.

Being your own advocate is difficult when you are the patient. Having a caring advocate is important. You may have a friend or loved one be the advocate.

Start as soon as possible researching the needs.

1. Is home alone an option? If not will someone be there to care for the patient? Are there monies to cover home care or insurance coverage for help at home?

2. Is a skilled nursing facility (SNF) needed? Start researching SNF’s to get answers to important questions. Based on insurance or cash pay call or Google local choices and see which options best fit your needs.


1. DISCHARGE TIMELINE: When is the patient expected to be transferred to the SNF? Ask about the possibility of nursing home care as soon as the patient is hospitalized to have time to research SNF’s and to prepare for this transition.

2. SNF CHOICES: Which facilities are available to the patient and do they have an open bed? Can the patient request a single room, and is there an extra fee?

3. TRANSPORTATION TO THE SNF: How will the patient be transferred to the SNF? If transportation by ambulance is needed, are the charges covered by insurance?

4. SNF REVIEWS: Consult Nursing Home Compare for SNF information. Google the name of the SNF and read any online reviews or comments. Contact your state Department Of Health and ask for the most recent inspection results.

5. SPECIAL NEEDS: Ask the hospital discharge planner or case manager if the patient has special needs that the SNF will need to provide, such as a special diet or onsite physical therapy (PT) or occupational therapy (OT) services.

6. VISITING THE SNF: The patient’s advocate should try to visit the SNF choices in person. Check the toilet and shower facilities, cleanliness, patient activities and food selections. What is the caregiver to patient ratio – especially during evenings and weekends?

7. PATIENT RISKS: Nursing home patients may be at an increased risk of infection, overuse of antibiotics leading to “superbug” infections that may not be curable, falls, malnutrition, dehydration, medication interactions and side-effects, pneumonia and depression. Report any unusual symptoms you may observe in your loved one.

8. COORDINATION OF CARE: Which staff member is responsible for coordinating the patient’s care? Who is the physician in charge and how can he/she be contacted if there is a concern? Will the patient’s regular doctor visit the SNF? How are emergencies handled?

9. VISITING POLICIES: Does the SNF have a written visiting policy? If so, ask for a copy. Can approved visitors stay all night? Is there a policy for bringing food or other comfort items from home?

10. INSURANCE COVERAGE FOR SNF’s: Are there any needed services that are not covered by insurance? Is there supplemental Medicare coverage that needs to be billed? What is the protocol if the patient meets or exceeds their insurance maximum?

©2015 The Empowered Patient Coalition. An Empowered Patient ® Publication in collaboration with Julia Hallisy, D.D.S. and patient advocates Judy Wehrer and Paula Jean.

Moving Away From Home

Keeping Control Is Still An Option With An Involved Caretaker

Don't wait for a crisis and have to do things quickly.  Urgency is sometimes unavoidable but planning ahead is always the better choice.

When the time comes to move your loved one into an assisted living, nursing home or board and care,  when it is unsafe to leave your love one alone for any amount of time, you must look at the possibilities.

Word of mouth is a great way. Start by asking anyone you know who visits someone in a facility. Ask your primary care physician where they go and see if that is a possibility. Ideally the closer to you is going to be less stressful for you to visit. You want to have a checklist.


What to Ask and What to Look For: A Facility Checklist

The following is only a partial list of things you should look for when selecting a retirement or nursing facility.

  1. ___ Look closely at the facility or home inside and out.
  2. ___ Ask to see the facility license.
  3. ___ Ask to see the admission agreement.
  4. ___ Take a look at the food menus.
  5. ___ Take a look at the kitchen.
  6. ___ Talk to the facility residents. Do they like their home?
  7. ___ Do the residents look comfortable and well cared for?
  8. ___ Talk to the staff.
  9. ___ Talk to the administrator. Is he or she helpful in discussing the facility or home with you?
  10. ___ Is there an odor in the facility or home?
  11. ___ Are the bedrooms clean and neat?
  12. ___ Are there activities for the residents?
  13. ___ Does the facility or home provide transportation?
  14. ___ Does this home specialize in difficult cases?
  15. ___ Do the residents appear to be clean and dressed?

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