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Nursing homes are an important part of ttie nation's health care delivery system Helping a loved one. (riend or relative selact and enter a nursing home can be a difficult experience, but it needn't be. The Better Business Bureau suggests,researching the options tofind the home that fits the requirements, tastes and personality of the potential resident. . Start by malting a list of the local facilities. Ask the patient’s doctor, clergyman, friends,, medical society, health department, local nursing home association, senior citizens' group or social Security office for suggestions It is best to begin with a number of choices and eliminate them methodically, to assure that the best choice will be considered. Some of these homes can be eliminated with a fewtelephone calls. Over the phone find out what each home provides and whether or not It participates in Medicaid and Medicare. Ask two more important questions:' 1. Does the home have a current license from the sta le? If the answer is "no" to either, cross that nursing home off the list. Every state requires a license to certify a level of service and experience.

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A home could also be eliminated if it does not provide the special services, diet or therapy that will be needed There is a wide range of homes and capabilities. Do not assume that specific needs can be met. Understanding g*vernment Assistance Nursing homes are not required to participate in Medicare or Medicaid. A decision not to is no reflection on the home’s competence. However, if the patient is eligible and in need of such assistance; that should be a determining factOT. Medicare will pay for nursing home care if the patient is eligible, is going to a home certified as a Skilled Nursing Facility, has just spent three consecutive days in a hospital and a physician certified that daily extended care services are needed. If these conditions are met Medicare will pay all the costs of the patient’s first 20 days at home and most of the cosjs for the next 80 days of care Far more nursing home assistance comes frbm Medicaid, the qualifying conditions for which vary from state to state. A local office of a slate health agency wiil be able to provide more specific information. With the list whittled down to a few choices, contact the local Better Business Bureau to obtain a reliability report] on each of the institutions. Then, make personal visits Call ahead, make appointments and, if possible, go at midday to observe the noon meal. Plan to spend as much time as necessary visiting each one, touring the facility and talking with administrators, staff and residents.

While visiting, make a mental checklist of the pros and cons. Consider such physical considerations as convenient location, accident hazards, fire safety, cleanliness and comfort. Observe the bedrooms, dining room, kitchen, lobby activity rootns, toilet facilities, grounds and any other places that tl^e residents spend their time. Ask about the medical services, therapy facilities, activities program, religious observances and social services. Try to assess the attitude of the staff, reactions of thq'current residents and the general atmosphere. If possible, bring the patient along and get him or her involved in the decision tnaking. Use an extra measure of understanding to protect the patient's self esteem at a time when some independence must be withdrawn.

The Admissions Agreement After a nursing home is 'selected, an admissions agreement must oe signed. This is essentially a service contract and should be approached with the caution due such an agreement. Read it all carefully, ask questions

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. 21 arM don’t sign it until it all make* sense. If necessary, take * the agreement to a lawyer or Legal Aid Society for assistance It-mny not be wise to sign an agreement that specifies a minimum period of time for the patient s stay The patient may improve more quickly thatn expected and will want to return 10 independent llvlqg. Beware ot home that ■ require a large deposit. This* may have the effect of locking in" someone who depletes his fife savings to make such a payment.

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