When in home care is not enough, or not an option, it may be time to consider a nursing home for your loved one. As the case often is, in home care is insufficient in fulfilling medical needs, despite how much you may want it to be. This is when exploring outside options will benefit everyone involved. The level of care at home, or the ability to to provide the right type of care can propel a family into researching the best available options for future health care with the main objective being the recovery of the patient. Nursing homes provide this care, along with other rehabilitation services that are dedicated to wellbeing and support for everyone involved.
In addition to being aware that your loved one’s medical needs have eclipsed what you as a caregiver are capable of, pay attention to your own needs and emotional wellbeing. Feelings of being overwhelmed, forgetful, frustrated, and overly stressed are a few signs you may need a break and to look into professional care. It can be very taxing caring for an elderly family member in addition to everyday life obligations such as employment, running a household and children. While it is admirable to care for an elderly person at home, it just may not be the healthiest choice for anyone involved.
What is a Nursing Home?
Nursing homes, or senior care facilities, provide licensed, necessary skilled medical care to the elderly who are unable to care for themselves for any number of reasons; nursing homes are essentially for those who have health concerns but do not need to remain in a hospital. Round the clock rehabilitative care is available including surgery recovery, physical, occupational and speech therapy, and mental health care. Recreational activities are offered as well. While they do provide residential facilities, the main objective of nursing homes is offering care to residents by the the dedicated staff of doctors and nurses.
Many of the residents are wheelchair bound or have decreased mental capacities (such as dementia), and nursing homes are tasked with maintaining the safety, health, and welfare of the seniors within the facility. These residents may not have family or friends able to care for them; even those residents who do have these people in their lives still exponentially benefit from being taken care of by medical professionals as opposed to well meaning, but untrained, individuals.Nursing homes aim to improve or restore health conditions to reduce further injury or deterioration in the quality of life.
Nursing Home Care
What type of care can a nursing home provide? Nursing homes, or skilled nursing care centers, offer a number of services both in the long and short term, depending on the severity of the care needed. Medical care, nursing, rehab, and personal care are all available. Medical care services can include working with a team of doctors, or more individualized one on one care with medical staff. Doctors will work with the resident, and/or their family members to develop the best course of treatment; including medications and exams. Nursing services include distribution of treatment (dispensing of pills/injections) and various therapies. Respiratory, physical, occupational, and speech therapy are all provided in nursing homes, and they will have procedures in place for transportation services to medical appointments off site.
- Respiratory: respiratory therapy is geared towards the heart and lungs; this requires an advanced practitioner in order to maintain the management of these systems, mostly due to sustaining some kind of trauma. Intensive care is often needed before /after surgery.
- Occupational: occupational therapy is concerned with fine and gross motor skills, with some sensory related issues. Occupational therapy focuses on accomplishing basic everyday tasks.
- Speech Therapy: Speech therapy is often used after strokes, accidents, or injuries. Going beyond simply learning to speak, speech therapy also entails improving language, communications and comprehension skills, eating, and swallowing.
- Physical Therapy: Physical therapy is used to relieve pain, restore mobility, and prevent further injury. While it is of course beneficial bodily, physical therapy is helpful for psychological and emotional concerns as well.
- Personal Care: Personal care aides residents with everyday activities such as help getting out of bed, bathing and toilet hygiene, help with dressing, mobility, and eating.
Nursing Home Services
Basic Services: The most basic services of a nursing home are a place to live, food, nursing, medical care, and social activities. A room may be private or shared ( much like a hospital room), and will be maintained by housekeeping staff along with laundry care.
Diet: Meals and diet should go along with any medical requirements and follow nutritional guidelines as set forth by a physician. It is very important the guidelines for a well balanced diet are followed especially in cases such as diabetes, high blood pressure, or heart conditions. Meals should be individually evaluated if needed, and maintained by staff to ensure the resident is eating properly.
Nursing: Likewise, nursing staff is on call 24 -7. Nursing homes are round the clock facilities due to the needs of the residents. Registered nurses, licensed practical and vocational nurses, and aides should all be on staff and available. Residents should also have access to an on site physician who consults regularly with the nursing staff on their day to day activities and health care needs and concerns.
Social: Social activities and interaction are vital to keeping emotionally and mentally healthy. Nursing homes may have daily calendars consisting of communal mealtimes, movies, holiday events, hobbies like arts and crafts, yoga, book clubs, or other activities such as pet therapy, board game nights, even day trips.
Finding a Nursing Home Near You
Before deciding on a nursing home for your loved one, you have to assess their care needs. Needs could include anything from medical necessities, to feeding themselves, to therapy and recovery. Finding the right nursing home can be a daunting task both emotionally and financially. It is not a decision to be made lightly. The more research you do, the better prepared and more informed you will be in undertaking what is potentially a life-altering situation.
Informing yourself, is of course, the best way to find out what is available and the questions you should be asking when touring facilities. Other great resources include:
Reach out to any medical professionals you or your loved one are currently in the care of. Their physician especially will know what type of care is needed in the long or short term.
Your community can be a wonderful asset; ask friends, neighbors, or co-workers if they have any first hand experience with nursing homes. You can be sure their reviews of any facilities are unbiased, something that is difficult to discern from online reviews from strangers or the facility themselves.
Social Care Workers:
The local hospital should have administrative workers who can assist in finding the right nursing home, or be able to direct you to an agency that specializes in such things.
The Internet can be a valuable tool when assessing businesses. There are a plethora of review sites online (Google, Yahoo, Yelp, etcetera) for just about anything you can think of. Joining online communities is beneficial, as you can ask for advice and experiences, and local online groups can be a resource for recommendations within the community.
Medical.gov is an official government sanctioned site where you can look at and compare reviews of facilities once you have narrowed down a list of nearby places.
After you’ve got your favorite selections on a long list and a short list, call the nursing homes to schedule a guided tour. This way you can see first hand what kind of facility it is and how they operate on a daily basis. Be sure to ask any questions and bring up concerns you may have. If specialized care is needed, check to see if the facility has the means to fulfill it. You may even have the chance to talk with nurses and other staff; in addition to the residents if permitted.
How to Select the Right Nursing home
There are a number of criteria to consider yourself with when investigating a nursing home. First, think about the needs of your family member. Next, create a checklist of amenities you both require of the facility to have. Write down any questions you have that can be answered either via your own research, and if not that way then asked about directly during a facility tour.
Before delving too far into the research and specifics of individual facilities, there are some prerequisite questions that should be answered. At the top of this list is:
- Are the care facility and all its staff certified and licensed providers?
- Does the facility meet and/or exceed state requirements?
- Are they accepting new patients?
- Do they accept Medicare or Medicaid?
- What is the waiting period (if any) for new resident admissions?
- How far is the facility from family members?
- How often do assessment/planning meetings take place to evaluate care?
Once these are answered to your satisfaction, you can continue examining and evaluating other criteria.
- Is the facility equipped with guard rails, ramps, and grab bars for residents?
- Are all the exits clearly marked and easily accessible?
- Are there smoke detectors and sprinklers, and where are they located?
- Is the facility well lit and are the rooms and halls cleaned within a reasonable timeframe?
- Are temperatures kept at a comfortable level?
Meal times can be fraught with anxiety. It’s important that the staff is equipped to aid residents who need help feeding themselves and maintaining their diets. Should there be specialized diets necessary, residents will need to be monitored to ensure they are following it. There should be a variety of menu options available that are healthy and appetizing, and time for residents to socialize with one another if they choose.
- What type of privacy is afforded the residents? Are single rooms available?
- What is the standard room size?
- Can rooms be personalized to an extent, and is there a private TV and phone in there as well as in a communal room?
- Are residents permitted to choose their own routines to a certain degree; for example when they wake up and go to bed?
- What are visiting hours?
- Is the kitchen open 24/7, and if not can approved snacks be kept in the residents’ room?
- Are there a large variety of social activities to choose from?
Level of Care:
What is nursing home level of care and why is it important?
Level of care determines whether or not someone is eligible to receive a Medicaid funded nursing home care term. Each state has its own rules and regulations regarding level of care, which presents an issue as there is no consistency. Typically, being eligible for this kind of care means the individual cannot care for themselves and they need assistance medically, and have impairments cognitive, behaviorally, and functionally. These impairments impact memory, actions, mood, and managing the activities of daily life.
When researching nursing homes be sure to seek out the level of care criteria for your state to see if your loved one qualifies, and if the facility can provide that care. Some states require a doctor’s diagnosis, and observation by therapists to determine what kind of assistance is needed. Some states look at the individuals family capabilities in conjunction with what kind of care they can or cannot provide.
Given that the staff is whom the resident will be interacting with on a daily basis, it is wise to not only questions hiring practices and routines but to become friendly with the people who will be caring for your loved one. Keep the lines of communication open with staff to work with them on a care plan, ensure that the plan is being followed, and work out viable solutions for what needs to change.
- Does the staff go through a background check prior to hiring?
- What types of training does the staff undergo, both upon hiring and as further education?
- Is there abuse prevention training?
- Is there training on how to deal with certain behaviors, for example, overt aggressiveness?
- Is there training on how to handle emergency and potentially dangerous situations that would warrant lockdowns?
- Are the staff warm, respectful, and respected in turn?
Depending on where you live, there may be a number of nursing homes to choose from. Each will have its own pros and cons. It is a good idea to compare these along with any reviews you come across of the facilities to help make a decision on which one is the best to suit your needs. You can use internet comparison tools to evaluate positive and negative comments, costs, and amenities.
Comparison charts will offer clear cut quantitative data, annual inspection reports on health, food prep, medicine management and facility performance reviews. Review sites should offer staff ratings and reviews as well on quality of care and the number of hours devoted to residents. You should also look for measures of the quality of overall resident wellness for things such as mental health and physical functioning, and be aware of any injuries that have been sustained by the residents. While it is encouraging to read positive reviews to bolster any thoughts you have formed on your own, it is likewise beneficial to read any negative feedback to get a full spectrum of opinions. Reading negative feedback can also open up conversations with administrators on how the facility has implemented procedures to change and improve incidents and prevent such situations from reoccurring.
Nursing Homes vs Assisted Living
Occasionally, nursing homes are conflated with assisted care facilities. Fundamentally, they are the same in which care is provided to the elderly. The difference lies in the independence of the residents. Whereas at a nursing home the resident would need help in the very basics of day to day living, a resident of an assisted care facility is much more independent. Nursing home living accommodations resemble hospital rooms, and assisted living facility are similar to apartments. Assisted care facilities are often used in the long term, nursing home care is typically a short term stay lasting a few months while a patient is rehabbed.
Assisted Living Centers
A relatively new concept, assisted living facilities have become an increasingly popular living option for senior citizens over the past 25 years. They offer a wide range of services to the elderly who may not feel comfortable living alone for any number of reasons, but do not need a level of care on par with the hospital like environment of a nursing home.
Assisted living, or residential care centers, offer people a place to live that resembles homes. Transitioning to a facility such as this can create emotional upheaval, especially if a senior is used to being completely independent. Assisted living, while providing care and some level of supervision, still provide the elderly with autonomy and the ability to live full balanced lives. Typically seniors receive support with bathing, dressing, medication distribution, meal times, and transportation. Laundry and housekeeping can be included services as well.
As with nursing homes, evaluating and touring should be done before choosing a facility, and familiarizing yourself with facility policies and features. Questions that should be investigated and ask include:
- Is an assessment of the potential resident required?
- What type of living facilities are available?
- Is there a waitlist?
- What is the cost associated with living there, and are there payment options?
- What is included in the fees – trips, meals, activities – or are they billed separately?
- Are animals permitted? This can be important either if your senior owns a dog, or is afraid of them.
- Do staff undergo background checks prior to hiring?
- What is the staff to resident ratio?
- What kind of training do staff undergo?
- Is there medical staff on call 24/7?
Staff especially is an important consideration when choosing an assisted living facility.
The relationship between staff and residents should be warm and compassionate. Turnover at a facility should be low, and if not it may indicate issues that are worth looking into. Staff who remain at facilities for longer periods of time get the chance to build a rapport with residents and provide the care needed to bond with them.
Socially speaking, it is important to find a facility that encourages engagement with other residents and offers daily activities and day trips. Loneliness plays a big role in emotional wellbeing and mental health, and its especially important for seniors who are widows or may not have close family around to be social to keep spirits up and stay active.
The number of residents can factor in a final decision, depending on the level of comfortability and how active they are normally. The purpose of assisted living is to live as close as possible to a regular home life, with minimal medical intervention.
In comparison to nursing homes, assisted living facilities typically cost less with prices ranging from $2,000 – $5,000 a month, and are not bound by federal laws that regulate mandatory medical presence at all times. State laws regulate assisted living facilities, and the laws differ from state to state.
As stated previously, nursing homes serve as residences for people who do not need hospital care but do need access to medical intervention 24/7. Nursing homes not only care for their residents medically, they also provide a social atmosphere with communal dining and activities. Many homes also have special memory care facilities for residents with Alzheimer’s disease, and specialized medical equipment such as dialysis machines that are not found in assisted living facilities. Residents in nursing homes are typically there for a short period of time, recovering from illness or surgery and can be bedridden or wheelchair bound. The residents are much less independent.
When looking at facilities, evaluate what the quality of life is like for residents (cleanliness of rooms, visiting times, are pets permitted, food choices), the quality of care offered (care plans, doctors, accepted insurance plans), and staffing (training, turnover, availability).
It is important to know the difference between nursing homes and assisted living facilities when deciding what kind of care is needed. Many people confuse the two, and while they are very similar, assisted living facilities do not offer the same level of medical care as nursing homes. Depending on the individuals needs, a nursing home’s care is more intensive, and they are also regulated by the Federal government whereas assisted living facility regulations vary from state to state. Nursing homes are also more expensive due to the level of care.
Skilled Nursing Facilities
What is the difference between a nursing home and a skilled nursing facility? The difference lies in the amount of time and care provided to residents. A skilled nursing facility will provide care, meal prep, and assistance in daily activites (much like a nursing home and assisted living facility), and in addition will have specialists on staff. Medical personnel such as rehab specialists, audiologists, pathologis, or speech therapists among others. Residents here are typically rehab patients who are staying after an emergency hospital stay and do not need long term service. Skilled nursing facilities operate as a transitional place to stay between hospitals and independent living.
Skilled nursing care is covered by Medicare in many cases, even if it is for a limited time. If a limit has been reached by Medicare, Medicaid may cover the difference. Some skilled nursing facilities are certified by Medicare as well. Knowing the ins and outs of the healthcare system is recommended, as a person must be qualified as eligible to stay at a skilled nursing facility and approved by Medicare and Medicaid for coverage. State rules and regulations vary by state, and your local state representative will be able to tell you more.
Transitional, or progressive care units function as an intermediary between intensive care units (ICU) and medical-surgical units. They provide high quality care for a variety of patient needs, however what these patients have in common is that they need elevated nursing care and surveillance, while still not being severe enough for a stay in an ICU. Residents of PCU’s are not ready to live at home, but do not require a longer stay at a nursing home. Many need monitoring for cardiac and pulmonary reasons. Patients may have an intense drug regime, have new pacemakers or defibrillators, or have suffered a stroke. Much of the staff in progressive care works in a smaller environment than regular nursing personnel, and are trained with more specialized technologies in addition to traditional nursing practices.
Nursing homes and assisted living facilities can both offer progressive care. Someone can begin their residence in progressive care, then once rehabbed to a certain level can move on to becoming more independent.
Nursing Home Costs
While discussing or evaluating finances can be stressful and emotional, it is a necessary part of the process in choosing a nursing home. Take into account personal circumstances, health care insurance, Medicare and Medicaid. It is advisable to look into getting professional guidance and opinions if the situation becomes too overwhelming. Costs will vary depending on a number of reasons:
- The type of care needed
- Whether care is short term or long term
- State to state / regional differences
- Facility amenities
- Room type
In the case of financial need, there are other avenues you can pursue such as aid from non-profits, government programs, and community based or faith services. Other ways to pay for nursing home care are: out of pocket, insurance, veteran benefits, or Medicaid.
Be sure to create a comprehensive budget plan, including estimates for emergencies and possible extras that may not be included in the regular monthly cost; such as therapy, medications, laundry services or activity fees.
Paying for Nursing Home Care
Staying in a nursing home is an expensive venture. There are a variety of options for payment possibilities, and many people will need to use multiple sources to help with expenses such as out of pocket, viatical statements, trusts, and veteran benefits. Despite the high costs, the AARP reports that the majority of nursing home residents do not pay out of pocket, and most receive outside help.
To protect your assets legally from being used for nursing home costs there are several things you can do to prevent them from being counted when your accounts are looked at.
- Monetary Gifts – before you ( or the relative you are looking into nursing homes for) enters a nursing home, give family or friends monetary gifts from your savings
- Hire an Attorney – In legalese, you can be named as a “life tenant” for your real estate, meaning you have the right to stay in your home until death. Afterwards, the title is transferred to a designee, and the state cannot make a claim on it. In other words, they cannot take the home away in lieu of payments. This option is subject to Medicaid investigation.
- Annuities – Liquid assets can be placed in an annuity, and are blocked from consideration when applying for government aid
- Spousal Payment – The income of spouses of nursing home residents is protected by federal law from asset evaluations when determining payment
- Irrevocable Trusts – An irrevocable trust is exempt from nursing home costs.
Pour over Trusts – A pour over trust protects assets while still allowing you access to your money, but it cannot be used for nursing home fees.
Nursing homes sometimes offer residents the option to open trust funds with them, allowing for the deposit of money the resident can use to pay for care, activities, or incidentals. This operation brings up the concern of proper money management, the potential for scams, and the trust fund policies & procedures of nursing homes. If this is an avenue your nursing home of choice has, familiarize yourself with the rules and precautions you can take to ensure your money is taken care of properly:
- Nursing home trusts are completely optional
- These trust accounts earn interest
- The money still belongs to you or your loved one
- You have the right to information on how the trust and the account is being handled by the nursing home
- Trusts must be insured by facilities as a safety measure
- If the nursing home resident passes away, any remaining funds must be transferred to next of kin within a certain time period
Turning over funds to a care facility is daunting. Along with the other research you perform when deciding on a home, be sure to check if the nursing home administration complies with all state and federal accounting guidelines. Regulations include keeping all resident funds separate from one another, disclosing dates, balances, and keeping track of receipts for validating transactions. All of this is done to prevent fraud and scams.
Out of Pocket Payments
Even if you do not initially wish to use private pay, you will be required to do so if it is determined you have enough income and assets. If at all possible though, paying privately and out of pocket is the ideal way to finance a nursing home stay. While expensive, the benefit to paying privately is having more flexibility – both in choices of locations, dealing with the paperwork approvals, and assessments in receiving money or subsidiaries from other funding sources. Utilizing savings, 401ks, life insurance, or pensions are some options to look at when privately paying. When, and if, your money runs out, there are other ways to take care of costs.
A viatical statement is added to an existing life insurance policy when policy holders have a less than two year life expectancy, in other words, are terminal. The statement permits the holder to cash in on a percentage of the policy for a tax-free lump sum. Policyholders can sell the policy to a third party, who then becomes the owner and pays premiums. The third party will also become the beneficiary after the policyholders passing – not any heirs. It is a good financial choice for the chronically ill, and the money received can be used towards any long term care and make the remainder of their life as comfortable as possible.
Veterans Affairs Benefits
Military veterans, categorized as anyone who has served active duty and honorably discharged or retired, and their dependents are entitled to receive benefits for service related injuries or long term care. The Department of Veteran Affairs website is a resource for information on eligibility and how to apply for pension benefits and services, and you can also search for nearby office locations. There is also the option for Veteran – only senior housing communities. These facilities provide care for veterans of all ages on an as needed basis. Veteran based nursing homes provide therapy, rehab, and social services.
Medicaid and Medicare
Medicare and Medicaid are synonymous with elder care. Understanding the Gordian knot of the specifics can take a bit of time. There are many requirements needed to qualify for these benefits and they can be confusing. When in doubt, contact a local representative to walk you through how to apply and if you are eligible to receive funds. Medicare and Medicaid can work in conjunction with one another to provide financial assistance.
Medicare is the social insurance program available to senior citizens ages 65 and over that have paid into it. It can cover hospital insurance, prescription drug coverage, and medical insurance. Long term care is not covered by Medicare. It will cover rehab, doctor visits, hospital stays, and provide nursing care in a skilled nursing facility for up to 100 days. Nursing homes are custodial, meaning they aid you in non-medical activities such as bathing or dressing, and Medicare does not cover that. It will however, cover some medications and short term nursing home care if the resident will be returning to their home within three months. Medicare also limits the choices of available nursing homes, as some facilities limit the number of people staying with them using this public benefit.
Medicaid is designed to provide benefits for people on a lower income scale and with limited financial resources, disabled, or blind. It is a federally funded program that works jointly with each state, that operates with its own requirements. Due to this non standardization, there are a number of disparities depending on where you live and what you can receive. Unlike Medicare, Medicaid does provide long term care. After medical and financial evaluations are performed and qualifications are met, Medicaid can be applied for. This can be done by contacting the Medicaid-accepting nursing home you are interested in. If you haven’t already looked into the type of care they provide and amenities available, it is advisable to do so before continuing with an application from your state office.
Each state has its own eligibility rules. Medicaid will cover long term nursing home care if a person meets the particular criteria for their state regarding health, income, and assets. Basic eligibility criteria relevant to nursing home stays includes low income senior citizens and those with documented disabilities.
Not all nursing homes accept Medicaid, and the ones that do often have a limited number of dedicated beds for people using the program. To see if you can apply for Medicaid you must first determine if you qualify, first by providing proof of US citizenship and state residency. This can be done by:
Receiving a medical assessment from a doctor. Each state has its own requirements here determining what a medical need and long term care is necessary
Meeting certain financial requirements, where income and assets will be evaluated. Eligibility varies between married and single individuals
Aside from Medicaid and Medicare requirements, nursing homes themselves have certain eligibility criteria a potential resident must meet.
- Payment information – a potential resident must provide how they will be paying for their care
- Health & contact information – including a comprehensive medical history, medications, personal contact information and contact information to reach in case of an emergency, and advance healthcare directives
- Personal needs accounts – funds for fees not included in your medical care
- Medicare and /or Medicaid information – the nursing home themselves must provide information on how to apply
Any nursing home facility will perform a physical assessment to check for any ongoing medical conditions, and may accept or reject an application based on if they can properly provide for that condition.
Nursing Home Regulation
How to ensure quality of care for yourself or your loved one? A number of protections are in place to assure high standards are being kept, and that they are qualified to accept Medicaid and Medicare. Licenses and regulations vary from state to state, and inspection reports are performed by unbiased third parties. Resident rights should be available for review along with those reports, which are done annually by a state board.
The Citizen Commission of Human Rights, a global group dedicated to investigating mental health violations and working with medical professionals on behalf of individuals to ensure their rights are upheld and they are treated humanely, have put together a mental health declaration of rights that aligns with the other “bill of rights” for nursing home patients.
Resident rights are guaranteed by major reforms passed in 1987 by Congress. Nursing homes must meet federal requirements for protecting these rights.
The rights are designed to ensure “quality of life of each resident, ensuring dignity, choice, and self-determination”. These rights include but are not limited to the following:
- Right of Citizenship – nursing home residents do not lose their citizenship rights, including the right to vote, religious rights, and to associate with who they decide.
- Right to Dignity – residents are guests and should be treated as such.
- Right to Privacy – residents have the right to privacy, right to their medical records staying private, and right to private communications.
- Right to Personal Property – residents have the right to possess and use their personal property how they wish and to stay in control of their financial affairs.
- Right to Information – residents have the right to information regarding the rules and regulations of the nursing home and its costs, and to participate in the discussions regarding their treatment, including refusal.
- Right to Freedom – residents have the right to be free from mental and / or physical abuse, from physical and/or chemical restraints, unless ordered by their personal doctor.
- Right to Care – residents have the right to care, treatment, and services provided by the nursing home without discrimination.
- Right of Residence – residents have the right to reside at nursing homes unless they breach the stated rules. If they are to be discharged they must receive proper notification.
- Right of Expression – residents have the right to express themselves, including the filing of grievances without fear of retaliation.
- Right to Visitors – residents have the right to visitors during the stated nursing home hours. According to federal law, homes cannot restrict visitors, however residents who are of sound mind can refuse to see anyone, including medical professionals.
If a nursing home is found to be out of compliance, enforcement of the Reform Act begins. Training of staff, enacting a plan of action for correction of violations, monitoring by the state, and denial of Medicaid and Medicare services are all sanctions that are put in place to remedy the issues.
Nursing Home Care FAQs
In addition to the important questions to ask when researching nursing homes, here are some common questions that may arise.
Can residents leave to visit home?
Typically residents can go out on day visits for activities or to visit families. Arrangements will need to be made in advance with the nursing home on the particulars.
Are pets allowed? Many residences do allow pets.
What kind of safety measures are in place?
Nursing homes can be equipped with security cameras to keep track of who is coming and going.
What happens in case of an emergency?
Staff is present 24/7 in nursing homes.
How big are the rooms?
Room size varies depending on the facility and if rooms are single or doubles.
Can couples reside together?
This will depend on the facility you decide on.
Is there a beauty salon onsite?
Most nursing homes do have a beautician or salon.