“Use your nose.”
That used to be standard advice given to people
searching for prospective nursing homes for
themselves or their loved ones.
The sentiment behind the advice was to prompt people
to use their olfactory sense to determine whether a
facility was clean, practiced proper hygiene, etc.,
explained James Ellor, Ph.D., professor in Baylor
University’s School of Social Work and gerontology
But now – during a time when nursing facilities and
hospitals pay extra for specially designed,
odor-neutralizing waxes and paint – people need to
be aware of more subtle clues to help them find the
During this year’s National Nursing Home Week (May
11-17), Ellor offers six questions people should ask
while investigating – and before choosing – a
1. What is the turnover rate for nurse’s aides?
“Nurse’s aides are the backbone of care,” Ellor
said. “In some cases, we’ve seen an average turnover
of three months. That’s not good.”
2. Does the patient’s doctor serve the facility?
“When you’re under the care of your physician,
you’re going to get better treatment,” Ellor said.
“Also, you need to assess the reputation of the
3. What is the status of the facility’s recreation
and social services?
In general, Ellor said, nonprofit facilities will
have more chaplains, social workers and recreation
therapists on staff than their for-profit
counterparts. He advises potential clients and their
families to check whether the recreation therapist
“Some facilities will hire someone who can operate
an arts-and-crafts system, but he or she is not a
certified therapist,” Ellor said. “The ideal
situation is for a certified recreation therapist to
be supervised by an occupational therapist on
He also advises to look for recreation and therapy
equipment, including stairs, therapy balls and other
rehabilitation tools. The presence of ample
equipment can be evidence of a thriving
rehabilitation and recreation program, he said.
4. What is the reputation of the nursing staff?
Ellor advises potential residents to do due
diligence by checking the facility’s record with the
state’s board of public health and by questioning a
nursing home ombudsman.
“A nursing home ombudsman can often tell you whether
a facility has had a number of problems,” he said.
“The board of public health can tell you if the
place has received any citations.”
5. Is the facility accredited?
Ellor said accreditation is not always a deal
breaker, but accreditation shows that the facility
has taken extra steps to comply with The Joint
Commission, formerly known as the Joint Commission
on Accreditation of Hospitals (JCOAH).
“A handful of nursing homes are accredited,” he
said. “This is strictly voluntary on the part of the
facility, but it shows that they’ve taken extra
6. How is the environment?
This question addresses everything from “Are there
plants in the rooms and hallways?” to “Is the
facility operated based on the needs of the staff or
the needs of the patient?”
Of the latter example, Ellor said, “Are the patients
awakened by the night shift in the wee hours of the
morning to accommodate staffing schedules, or are
they allowed to wake up on their own time?”
Ellor said organizations such as Pioneer Project and
Eden Experiment monitor these types of things and
can provide reliable resources for investigation
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