25 Things Nursing Homes Don't Want You To Know

25 Things Nursing Homes Don’t Want You To Know


When it comes to elder care, nursing homes are considered as reliable long-term care facilities. However, beneath the surface, there are hidden truths that they don’t want you to know. From staffing issues to medication mismanagement, there’s more to nursing homes than meets the eye.

But did you know that there’s one crucial aspect that nursing homes often try to hide? It challenges the common belief that nursing homes always prioritize the well-being of their residents. Can you guess what it is?

Staffing Issues and Shortages

Many nursing homes across the United States are grappling with significant staffing issues and shortages, which have been exacerbated by the COVID-19 pandemic. These staffing challenges directly impact the quality of care provided to residents and can even result in admissions being turned away.

When considering a nursing home, it is crucial to prioritize facilities with low staff turnover and adequate nursing hours per resident. Adequate nursing hours ensure that each resident receives the necessary attention and care they deserve.

The “gold standard” for nursing hours is a minimum of 4.1 hours of direct care per resident per day. This ensures that residents have access to consistent and quality care throughout their stay in the nursing home.

Staffing levels can vary widely from one facility to another, so it is essential to ask about staff turnover rates and staffing ratios during the decision-making process. By understanding the staffing situation, you can make a more informed choice about the nursing home that will provide the best care for yourself or your loved ones.

To illustrate the importance of staffing in nursing homes, consider the following:

“Ample staffing levels are essential for ensuring that residents receive the care they need and deserve. Inadequate staffing can increase the risk of neglect, medication errors, and other quality-of-life issues for residents.”

It is crucial to keep staffing issues and shortages in mind while selecting a nursing home. By prioritizing facilities with low staff turnover and adequate nursing hours, you can help ensure that your loved ones receive the quality care they deserve.

Hidden Costs

When considering nursing home care in America, it’s important to be aware of the potential hidden costs that can arise on top of the already expensive price tag. While Medicare coverage is available for nursing home care, it only covers a small portion of the total costs and under certain criteria. To avoid any financial surprises, it’s crucial to understand the additional fees that may be incurred during your stay.

Let’s take a closer look at some of the potential additional fees that you should be aware of:

  1. Intake Health Assessments: Some nursing homes may charge an additional fee for conducting initial health assessments upon admission. These assessments are essential for evaluating the resident’s needs and developing an appropriate care plan.
  2. Leave of Absence Fees: If a resident needs to leave the nursing home temporarily, such as for a family event or hospital visit, certain facilities may charge a fee to hold their bed and room during their absence.
  3. State Fees or Taxes: Depending on the state you live in, there may be additional fees or taxes imposed on nursing home stays. It’s essential to inquire about any state-specific charges that may apply.
  4. Cost Fluctuations: Nursing home costs can fluctuate over time due to various factors such as changes in facility expenses or modifications to caregiving services. It’s important to clarify whether the charges are fixed or subject to adjustment.
  5. Additional Services Beyond the Basic Contract: Some nursing homes offer additional services or amenities beyond the basic care contract, such as hairdressing, transportation, or social activities. These services often come with an extra cost, so it’s important to understand what is included in the base price and what constitutes an additional expense.

Understanding these potential hidden costs will help you budget appropriately and avoid any financial surprises. It’s recommended to discuss these fees in detail with the nursing home administration before making a final decision.

Image: Nursing home costs may include additional fees on top of the base price.

Inspection Records

State survey agencies conduct regular inspections at nursing homes to ensure compliance with regulations. These inspections assess resident care, processes, interactions, and the overall environment. Inspection teams create reports noting any deficiencies and rate the facility’s performance.

It’s important to check with the applicable state agency to see if a specific facility has been cited or if there are any recent issues noted in inspection reports. This information can help in making an informed decision about a nursing home.

Recent Inspection Reports

Date Facility Deficiencies
March 2021 Graceful Gardens Senior Living 6
May 2021 Pleasant View Nursing Center 3
June 2021 Evergreen Assisted Care 2

By reviewing inspection records and deficiencies, you can gain insight into a facility’s adherence to regulations and the quality of care provided. Remember to consider the seriousness of the deficiencies and whether they have been addressed or resolved.

Next, I’ll discuss another important aspect to consider when choosing a nursing home: the ownership information and its impact on quality of care.

Unclear Ownership Information

Nursing home ownership can be complex and difficult to track. Many facilities have divided ownership among multiple parties, making it challenging to determine who is responsible for quality of care. Understanding the ownership structure is crucial in assessing the facility’s management and accountability.

In an effort to provide transparency, the Biden administration has announced plans to examine ownership roles in nursing homes. By shedding light on the ownership structure, it becomes easier for individuals and families to make informed decisions when selecting a nursing home.

To facilitate this process, there is a nursing home ownership database available. This database allows individuals to find out who owns a specific nursing home and provides ownership information for better understanding the facility’s background and affiliations.

Benefits of Accessing Nursing Home Ownership Information

Accessing nursing home ownership information through the database offers several benefits:

  • Transparency: The ownership database promotes transparency by providing insight into the individuals or entities responsible for the nursing home’s operations.
  • Accountability: Understanding the ownership structure allows individuals to hold the appropriate parties accountable for the quality of care provided in the facility.
  • Legal Protection: Ownership information can be crucial in legal matters, such as filing complaints or seeking legal recourse in case of negligence or abuse.
  • Decision Making: Knowing the ownership details helps individuals and families make well-informed decisions about the suitability and reliability of a nursing home for their loved ones.

By utilizing the nursing home ownership database, individuals can gain valuable insights into the facility’s ownership structure, fostering transparency, accountability, and informed decision making.

Benefits of Accessing Nursing Home Ownership Information
Legal Protection
Decision Making

Medication Mismanagement

Effective medication management is essential in nursing homes to ensure the well-being and safety of residents. However, despite best intentions, medication errors can occur, which can have serious consequences for residents’ health.

Issues such as administering the wrong dosages, missed doses, or improper administration can put residents at risk and negatively impact their overall health. It is crucial to be proactive and inquire about incidents of medication mismanagement when considering a nursing home.

One way to address medication errors is through open and transparent communication with the nursing home staff. By maintaining a collaborative relationship, caregivers can actively participate in their loved one’s medication management process.

Regular and effective caregiver communication serves as a valuable tool in ensuring that medications are delivered in a safe and timely manner. It allows caregivers to express their concerns, ask questions, and stay informed about any changes in medication or treatment plans.

Additionally, it is essential for nursing homes to provide thorough training and support to their staff regarding proper medication management protocols. By investing in staff education and training, nursing homes can minimize the occurrence of medication errors and improve overall resident well-being.

The Role of Caregiver Communication in Medication Management

Caregiver communication plays a crucial role in medication management within nursing homes. Through effective communication, caregivers can:

  • Share important information about the resident’s medical history, allergies, and reactions to medications.
  • Provide insights into the resident’s medication preferences and any challenges they may face in taking medications.
  • Keep the nursing home staff informed about any changes in the resident’s condition or medications prescribed by other healthcare professionals.

By actively engaging in medication management discussions, caregivers can help identify potential issues and work collaboratively with the nursing home staff to ensure the resident’s medication needs are met effectively.

“Clear and open communication between caregivers and nursing home staff is crucial in preventing medication errors and promoting the well-being of residents.”

It is important for both caregivers and nursing home staff to establish a trusting relationship based on effective communication. Through ongoing dialogue and shared responsibility, medication mismanagement can be minimized, ensuring a safer and more supportive environment for nursing home residents.

Recurring Complaints by Residents and Families

When it comes to choosing a nursing home, it’s important to be aware of any recurring complaints made by residents and their families. These complaints are indicative of underlying issues that could potentially impact the quality of care provided. In such cases, nursing home ombudsman programs play a crucial role in addressing and resolving these concerns.

Nursing home ombudsman programs are designed to advocate for the rights, safety, health, and welfare of nursing home residents. They work closely with residents, their families, and the facility staff to ensure that any complaints or grievances are handled efficiently and effectively.

Common complaints that may arise in nursing homes include improper eviction or discharge planning, unanswered requests for assistance, lack of respect for residents, medication administration problems, and quality of life issues. These concerns can significantly impact the well-being and comfort of residents and should be taken seriously.

By being aware of these recurring complaints, you can make a more informed decision when choosing a nursing home for yourself or a loved one. It’s essential to inquire about the facility’s process for addressing and resolving complaints, as well as the ombudsman program’s involvement in the resolution.

“Being aware of recurring complaints can help you make an informed decision about a nursing home.”

Remember that the well-being and quality of life of your loved ones should be the top priority. By staying informed and advocating for their rights, you can ensure they receive the care and attention they deserve.

nursing home ombudsman

Common Complaints in Nursing Homes

Complaints Description
Improper Eviction or Discharge Planning Instances where residents are unjustly evicted or discharged without proper planning and consideration for their well-being.
Unanswered Requests for Assistance Times when residents’ requests for help or assistance go unanswered or are not addressed in a timely manner.
Lack of Respect for Residents Situations where residents are not treated with dignity, respect, or courtesy by staff members or other residents.
Medication Administration Problems Instances of medication errors, missed doses, or improper administration that can pose risks to residents’ health.
Quality of Life Issues Concerns related to the overall quality of life in the nursing home, including the cleanliness of the environment, the provision of social activities, and the availability of nutritious meals.


When it comes to selecting a nursing home for yourself or a loved one, it’s crucial to have all the necessary information at hand. Nursing homes may try to keep hidden issues under wraps, but being aware of the potential pitfalls can help you make an informed decision.

From staffing shortages to hidden costs, medication mismanagement to recurring complaints, it’s important to thoroughly research and evaluate nursing homes before making a selection. Look into the facility’s staffing levels and turnover rates to ensure that your loved one will receive the quality care they deserve. Consider the hidden costs that may arise and make sure to budget accordingly.

Inquire about a facility’s medication management protocols and communication practices with caregivers to ensure that medication errors are minimized. Pay attention to any recurring complaints from residents and their families, as these can be a telling sign of the quality of care provided.

Remember, selecting a nursing home is a weighty decision. Take the time to visit potential facilities, ask questions, and advocate for the best possible care for your loved ones. By staying informed about nursing home abuse, elder care, and the facility selection process, you can make the right choice for your family’s needs.


What are some common staffing issues in nursing homes?

Many nursing homes experience severe staff shortages, which can directly impact resident care and lead to admissions being turned away.

How can I assess the staffing levels in a nursing home?

It’s important to ask about staff turnover and staffing ratios when considering a nursing home. The “gold standard” is a minimum of 4.1 hours of direct care per resident per day.

How much does nursing home care cost?

Nursing home care in America can be expensive, with the average yearly cost for a semi-private room totaling $94,900. Medicare only covers a small portion of these costs, and additional fees can also arise.

What additional fees should I be aware of when considering a nursing home?

Additional fees that can arise include intake health assessments, leave of absence fees, state fees or taxes, cost fluctuations, and additional services beyond the basic contract.

How can I find out if a specific nursing home has had any deficiencies?

It’s important to check with the applicable state agency to see if a specific facility has been cited or if there are any recent issues noted in inspection reports.

Who is responsible for the quality of care in a nursing home?

Nursing home ownership can be complex, but a nursing home ownership database is available to find out who owns a specific nursing home. Understanding the ownership structure can provide insight into the facility’s management and accountability.

What are some common medication management issues in nursing homes?

Medication errors, such as wrong dosages, missed doses, or improper administration, can occur in nursing homes. Open and transparent communication with caregivers is key to ensuring proper medication management.

Are there any programs to address complaints in nursing homes?

Nursing home ombudsman programs handle complaints related to resident safety, health, welfare, and rights. It’s important to be aware of any recurring complaints to make an informed decision about a nursing home.

How can I ensure quality care in a nursing home?

Thoroughly researching and evaluating nursing homes, visiting the facility, asking questions, and advocating for the best possible care are all important steps in ensuring quality care for your loved ones.

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