CNCINNATI — Linda Hayes said the hardest thing she's ever done is place her husband, Bob, in a nursing home, knowing he will probably never come home again.
Her husband of 47 years suffers from Lewy Body Dementia, which causes him to hallucinate and have delusions, Hayes said. The disease can also make him angry and confrontational.
"It's just not fair," Linda Hayes said as she fought back tears. "He was the most kind, loving man you'd ever want to meet."
The challenge of finding the best care for her husband got harder during the pandemic, she said. She had the support of family and friends, but like many people, she was unaware that she could review detailed inspection reports for nursing homes to help inform her decision.
"No, I didn't even know to ask for that," she said.
After states banned visits for months during the pandemic, nursing homes have opened up again as they try to rebound from the worst days of the pandemic.
COVID-19 has killed nearly one out of every 10 nursing home residents, according to The COVID Tracking Project.
There's still so much many of us don't know about living conditions in local nursing homes. So, the WCPO 9 I-Team is trying to make it easier for you to get the information you need to find the best available care for your loved ones.
The I-Team has spent the last two months reviewing records for local nursing homes, including their ratings and inspection reports.
We've created interactive maps showing where you can find the highest- and lowest-rated nursing homes in the Tri-State and important information about each of those facilities.
We also interviewed advocates for nursing home residents and their families who shared key information that helps them identify quality long-term care.
Where to begin
The first step is identifying the type of care your loved one needs. Some people require skilled care, the highest level of long-term care. These facilities have around-the-clock nursing care.
People with Alzheimer's may need what's called memory care: Many people just need help with meals and basic services; those with Alzheimer's typically require assisted care.
The I-Team collected and reviewed records for facilities providing each type of care and the contact information for those facilities.
"It's important to have them close because you are going to be their biggest advocate," said Ashley Burke, an elder law attorney in the firm Burke & Pecquetin Blue Ash.
Burke helped Linda Hayes with legal issues arising from the care her husband requires.
"It's not about the amenities or the decorations," Burke said. "It's about the care that the staff is providing."
A good place to start looking at quality of care is the Medicare nursing home compare website. It uses a five-star rating system. One star means the lowest rating; five stars mean the highest. It allows you to easily find facilities close to you by entering your address, then using other filters to identify nursing homes within a certain distance.
The website also provides details from federal nursing home inspections of the nursing homes, including any fines paid by the nursing homes.
The I-Team found 113 long-term care facilities within 20 miles of downtown Cincinnati. Twenty-six of them had an overall one-star rating.
Eighteen received an overall five-star rating.
The website breaks down the ratings into different categories: health inspections, staffing and quality of resident care.
The ratings provide a basic guide, but the I-Team found some nursing homes paid fines for poor resident care and still received a higher rating than facilities that had less serious violations.
One other important note: The ratings are based on previous inspections. They are not necessarily an accurate reflection of current conditions.
Still, the I-Team's investigation found the website is useful as a screening tool as part of your research on nursing home care.
Our interactive maps use data from the Medicare website. Each nursing home has a page in our database that contains a link to their individual Medicare inspection data and ratings.
We also included a link to an ongoing investigative project by nonprofit journalism organization ProPublica, which provides a rich collection of additional information about each facility, including the number of COVID-19 cases and deaths, along with actual inspection reports for the facilities.
The inspection reports are the most detailed public records available on individual nursing homes. The most serious violations are classified as "IJ" for "Immediate Jeopardy."
Inspection reports include the nursing home's response and a plan to address violations.
Visit, pay attention and ask questions
Before COVID-19, Linda Hayes said she made unannounced visits to nursing homes and requested a tour.
"That's when you really see what goes on behind the scenes," she said.
Something Linda Hayes said is most important to her is that her husband is close to her. He has lived in four different long-term care facilities, and each one has been 10-20 minutes from her home, which makes it easier for her to visit him more frequently.
"I just want him to be happy, if that's possible," she said.
Advocates for nursing home residents say regular visits lead to better care.
"They're going to be able to be more involved," said Betheny Breckel, who worked as a nursing home social worker for 15 years before she became the district ombudsman for the Northern Kentucky district. "They're going to be able to see if their loved one is getting the care they're needing."
There's a Long-Term Care Ombudsman program in every state, providing guidance for families looking for nursing home care and acting as advocates for residents in those facilities.
Jodi Holsclaw, the regional ombudsman overseeing Northern Kentucky, said guests should eat meals served in the nursing home so they can see the quality of food being served.
"I always encourage families to do that," Holsclaw said. "Is it appetizing? Does it look appetizing?"
Holsclaw said visitors should pay attention to details that can reveal a lot about how the staff cares for residents.
"Are there spills on the floor," Holsclaw said. "Are residents unkempt? Is their hair really long? Are their nails really long?"
Medicare publishes a nursing home checklist that can help your research, and Burke called the checklist "a good starting point."
While there is so much to consider when making such an important decision, Linda Hayes said it comes down to getting the best care you can afford as close to home as possible.
Then, share what you've learned.
"I hope it helps a lot of people," she said. "If it even helps one person, it will make me happy."
- Pro Seniors’ Long-Term Care Ombudsman program serves residents in Butler, Clermont, Clinton, Hamilton, and Warren counties in Southwest Ohio.
- Indiana Long-Term Care Ombudsman program
- Kentucky Long-Term Care Ombudsman program