The Senex | No.14
Wiser Older (Hu)man
By: Jeremy L. Pryor Esq. | May 3, 2019
Dear Reader—
This week we’re focusing on nursing homes. Spurred by an article that appeared in the Daily Progress this week, we thought you might appreciate our perspective on the current state of this long term care option.
The article that caught our attention can be read at the link above. However, we wouldn’t recommend it to the sensitive because it reads like a catalogue of terrors. In researching the performance records of nursing homes in the Hampton Roads area and reaching a rather modest conclusion (“Frequent injuries, low staffing persist in Hampton Roads nursing homes”), the paper featured some of the worst incidents of abuse and neglect it discovered. While these anecdotes are unquestionably an important part of the picture, we’re not convinced that the state of nursing homes in the Commonwealth is as bad as the article would lead one to believe.

Reading the Daily Progress article prompted us to recall another story that we read about nursing homes from a few months ago. This one (from the New York Times ) took notice of the fact that 200-300 nursing homes are closing nationally each year and attempted to understand why this would be happening even as the US population is generally getting older. The reasons offered range from ‘more options for today’s consumers’ to ‘changes in federal regulations’ (see The Senex , No. 11 for an example of the latter). Regardless of whether these facts answer the question, the result of a declining census in nursing home populations is to increase pressure on these communities to find ways to remain financially viable. And that will affect staffing.
Here both articles agree on one conclusion with which we also concur: the single most important factor in the quality of care that a nursing home provides is its staffing. But it’s not as simple as the staff-patient ratio that counts here; that matters, but so does whether the staff are adequately trained for the patient populations they serve and whether the staffing level is appropriate for the types of needs that the residents within the nursing home present. It’s also important to keep in mind that these factors change often and quickly, and so what may be a great community today may not be so great tomorrow. 
For these reasons, we often refer our clients to other knowledgeable professionals for guidance. The Centers for Medicare and Medicaid Services (CMS) also publishes a tool that our clients find useful, but in the end there is no substitute for doing your own in-person review. Visit the community and meet the administrators and staff. See for yourself what it’s like today; then keep spot-checking as long as anyone you know is there. And if you need advice on legal options for anything that comes up during your loved one’s stay, call us.
Happy Friday,
About The Senex
Carrell Blanton Ferris & Associates’ weekly update on aging, wisdom , and the law   | Edited by Jeremy L. Pryor, Chair of the firm’s Elder Law Section