Q: My husband is in the hospital and they said he will need to go to a rehab facility. How do I know what facility to choose?

A:  Finding the right skilled nursing facility for your husband to rehabilitate in until he can go home safely can be a worrying process. We want the best care and environment for our loved ones as they recover, and this will make the process of selection feel extra stressful. The choices are often limited based on availability or insurance. You may only be given a day or two’s notice before discharge. You can do your due diligence to make the best selection possible, and even if you are unable to get him into the facility of your first choice, there are still ways to get the most out of his time in the rehab.

The hospital will provide you with a list of facilities and ask you to select your top choices. Then it will depend on who has room available and will accept your husband into their care. You may only be left with a few choices. The first thing you can do is look up the Medicare rating of the different facilities. Go to: https://www.medicare.gov/care-compare/?providerType=NursingHome&redirect=true and type in your zip code and search. Each facility listed will show their overall star rating. This is a rating between 1 and 5 based on facility performance on three types of measures: 1) Health Inspections Rating, 2) Staffing Rating and 3) Quality Measures Rating.

The ratings are useful tools to help guide you as you narrow down your search. The next best way to select a facility is to talk to family or friends who have had direct experiences with the facilities. If you have time to visit the facilities, then it is recommended you show up unannounced to get a feel for the facility. Due to COVID there may be more specific visitor rules so you will want to ask first. However, having access to visit your loved one will be an important part of their care.

When visiting, get a feel for the energy. Consider the smell, the look and the sounds. If it is during a mealtime, look at how the food is prepared and served, and if the residents seem content and cared for. Ask questions about any specific needs your husband may have for care or even dietary restrictions. Notice if the staff takes time to answer questions in a caring and thoughtful way. Look at the physical therapy equipment and ask about the rehabilitation services they provide.

Location is very important when considering choice of facility. Visiting your husband frequently and at different times of the day will help ensure the staff knows you may arrive at any time. You will want to be able to monitor his care and progress. Visits will also improve his mood and motivate him to engage and participate in the rehab activities so he can improve and be discharged home. 

Once you have selected the facility and your husband has been transferred, get to know the staff and their names. This will not only help the staff get to know your husband and his needs, it will also make your husband feel more comfortable in this new setting. Treat the staff as your care partners and work together to make sure your husband has what he needs to gain strength and recover.

Talk with the staff right from the start about what the goals of care are and what will indicate when he is ready to return home. Think about what you need to bring him home. Will you physically be able to care for him? Does he need to gain strength so he can transfer and bathe himself? Talk with staff about these indicators early in the rehabilitation process.

Selecting facilities is often not a simple or perfect process. Be gentle to yourself and accept there are limits to your choices. You will be thoughtful and make the best selection with the options you have. Once there, you can help your loved one feel comfortable and stay involved in their care.  These transitions can feel stressful and you may feel a weight of responsibility in this process. Take time to care for yourself and your own needs as your husband will continue to need your help and support when he returns home.

Martha Shapiro can be reached at Senior Concerns at 805-497-0189 or by email at mshapiro@seniorconcerns.org

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