How to Verify a Nursing Home’s Safety Record Before Choosing One

Choosing a nursing home for yourself or a loved one is a massive decision. You’re entrusting a facility with someone’s well-being, their health, and their daily life. You want peace of mind, not a lurking fear that something’s amiss.

The reality is, the quality of care varies wildly. And if you don’t dig into a nursing home’s safety record, you’re essentially gambling with a person’s quality of life. That’s not a bet anyone should take. If something feels wrong, Charleston nursing home abuse lawyers can help you investigate and protect your loved one’s rights.

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Why Bother? Because Safety Isn’t a “Nice-to-Have”

You might think, “It’s a licensed facility, surely it’s safe?”

Well, a license means it met some minimum standards… at some point. It doesn’t mean it’s consistently excellent, or even consistently good. Residents in nursing homes are, by nature, vulnerable. They rely on the staff for basic needs, medical attention, and protection. Unlike choosing a restaurant where a bad meal is the worst outcome, lapses in safety in this context lead to serious harm, neglect, or abuse.

The statistics on elder abuse and neglect aren’t pretty. The National Institute on Aging (NIA) outlines various forms of elder abuse, including physical abuse, emotional abuse, neglect, and financial exploitation, all of which occur in institutional settings if oversight is poor.

Kicking Off Your Investigation: The Digital Detective Work

Thankfully, the internet allows much of the initial digging to be done from your couch. Several databases exist to give you a starting point on a facility’s performance.

Medicare’s Care Compare: Your First Stop

The federal government runs a handy tool called Medicare Care Compare. This website is your primary resource for comparing nursing homes that are certified by Medicare and Medicaid. It’s not perfect, but it’s a solid place to begin.

What you’ll find here includes:

• Overall Star Rating: A 1-to-5-star rating based on health inspections, staffing, and quality measures. Take this with a grain of salt – a high rating is good, but drill down into why it got that rating;
• Health Inspections: Details from recent inspections, including any deficiencies found, their severity, and how the facility compares to state and national averages. This is gold;
• Staffing Data: Information on registered nurse (RN), licensed practical nurse (LPN), and certified nurse aide (CNA) hours per resident per day. More on why this matters later;
• Quality Measures: Data on various aspects of resident care, such as rates of pressure ulcers, falls, urinary tract infections, and use of antipsychotic medications. These give clues about the consistency of care.

Spend time clicking through all the tabs for any facility you’re considering. Look for patterns, not just isolated incidents.

State-Level Resources: Getting Local

While Medicare provides a national overview, your state’s health department often has more granular information or different reporting details. For those in South Carolina, the South Carolina Department of Health and Environmental Control (DHEC) is the agency responsible for licensing and regulating nursing homes. Their website should allow you to search for facilities and access inspection reports and complaint investigations.

State reports might sometimes be more up-to-date or offer a different lens on local enforcement priorities.

ProPublica’s Nursing Home Inspect: Another Layer of Scrutiny

For an alternative view or to cross-reference government data, ProPublica, an independent, nonprofit newsroom, maintains its own database called Nursing Home Inspect. This tool compiles data from government inspections and presents it in a searchable format. It highlights serious deficiencies and penalties, sometimes making patterns of poor care easier to spot than on government sites alone. It’s particularly good for seeing fines levied against facilities, which is a pretty clear indicator of significant problems.

Cracking Open Inspection Reports

Inspection reports are the nitty-gritty. Surveyors visit nursing homes (usually unannounced) to check if they’re meeting federal and state standards. When they find something wrong, it’s called a “deficiency.”

Pay attention to:

• The type of deficiency: Is it related to food safety, medication errors, resident rights, quality of care, or building safety (like fire hazards)?;
• The scope and severity: This is key. Deficiencies are typically categorized by how many residents were affected (scope: isolated, pattern, widespread) and the level of harm (severity: minimal harm, actual harm, or immediate jeopardy to resident health or safety). “Immediate jeopardy” is a massive red flag;
• Repeated deficiencies: If a facility gets cited for the same problem over and over again, it suggests they’re not fixing the underlying issues. This is a sign of systemic failure, not an oopsie;
• Dates of inspections: More recent reports are obviously more relevant, but a pattern of problems over several years is also a bad sign.

Don’t just look at the number of deficiencies. One extremely serious deficiency (like one that caused actual harm or immediate jeopardy) is far worse than several minor, isolated ones that were quickly corrected.

The Staffing Situation: Who’s Actually Caring for Residents?

This one’s a biggie. Even with the fanciest building in the world, if there aren’t enough qualified staff, or if they’re constantly overworked, care will suffer. It’s just a fact.

Look at the staffing data for:

• RN hours per resident per day: Registered Nurses have the highest level of training and are critical for assessing residents and managing complex medical needs;
• Total nurse staffing hours (RN, LPN, CNA) per resident per day: This gives you a broader picture of how much direct care time residents are likely to receive.

Compare these numbers to state and national averages. Significantly lower staffing hours, especially for RNs, should make you very wary. High staff turnover is another bad omen, though this isn’t always transparently reported on these sites (more on how to find this out later).

Quality Measures: The Outcomes of Care

Quality measures are like the facility’s report card on specific health outcomes. These include things like:

• Percentage of residents with pressure sores (bedsores);
• Percentage of residents who have had falls (with or without injury);
• Percentage of long-stay residents receiving antipsychotic medication (sometimes overused for behavioral control);
• Rates of urinary tract infections (UTIs);
• Vaccination rates for flu and pneumonia.

Again, compare these to state and national averages. If a facility is consistently performing worse than average on multiple quality measures, that’s a strong signal that something isn’t right with their care processes.

Complaints and Penalties: When Bad Things Happen

Look for a history of substantiated complaints. These are complaints filed by residents, families, or staff that were investigated and found to be valid. A pattern of similar complaints (e.g., many complaints about call lights not being answered, or medication errors) is a serious concern.

Also, note any penalties, such as fines or a temporary ban on new admissions. These are typically reserved for more serious violations or failures to correct problems. A facility that’s been fined multiple times has a problem, period.

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Beyond the Pixels: Boots-on-the-Ground Reconnaissance

Online research is indispensable, but it’s not the whole story. You absolutely must visit the facilities you’re seriously considering.

If you can’t visit in person for some reason, a detailed virtual tour and extensive conversations with staff are the next best thing, though nothing replaces being there.

The In-Person Visit: Trust Your Senses

When you visit, go beyond the curated tour if possible. Pay attention to everything:

• Cleanliness and Odors: Does the facility look and smell clean? Persistent unpleasant odors (especially urine) indicate inadequate care or staffing;
• Staff Interactions: How do staff members speak to and interact with residents? Do they seem rushed, stressed, or genuinely caring? Are call lights being answered promptly?;
• Resident Engagement: Are residents active and engaged, or are most of them isolated in their rooms or parked in front of a TV with no interaction? Look for activities and social opportunities;
• The General Vibe: Does it feel like a welcoming, vibrant place, or does it feel institutional and depressing? Trust your gut feeling here, it matters.

Try to visit more than once, perhaps at different times of the day or on different days of the week (like a weekday versus a weekend) to get a fuller picture. Meal times are particularly revealing about staffing and assistance.

Talk to People: Get the Unfiltered Scoop

Numbers and reports are one thing; human experience is another. Try to (politely and respectfully) speak with:

• Current Residents and Their Families: If the opportunity arises naturally, ask about their experiences. What do they like? What are their concerns? You often get some very candid feedback;
• Nursing Home Administrators and Key Staff: Come prepared with specific questions based on your online research. Ask about staffing levels, staff turnover rates (this is a big one!), how they handle complaints, and their philosophy of care. Their willingness to answer transparently is telling;
• The Long-Term Care Ombudsman Program: This is a seriously underutilized resource. Each state has a Long-Term Care Ombudsman Program. These are advocates for nursing home and assisted living residents. They provide information about specific facilities, common complaints they receive (without violating confidentiality), and residents’ rights. They work to resolve problems and improve care. They can’t tell you “don’t go here,” but they provide invaluable context.

In South Carolina, residents of long-term care facilities have rights protected by law, such as the Protection of Rights of Patients in Long Term Care Facilities (South Carolina Code of Laws Title 44, Chapter 81). Being aware of these rights helps you know what to expect and what to demand.

Flashing Red Lights: Deal-Breakers to Watch For

Sometimes, the warning signs are subtle. Other times, they’re practically screaming at you. Here are some red flags that should make you pause, if not run in the other direction:

• Persistently High Staff Turnover: If staff are constantly leaving, it’s often a sign of poor management, low morale, or burnout. This directly impacts the consistency and quality of care;
• A String of Bad Reviews or Complaints Focusing on Similar Issues: One or two disgruntled people is one thing. A pattern of reviews all complaining about neglect, unanswered call lights, or poor communication is another;
• Evasive or Defensive Answers from Management: If you ask reasonable questions about staffing, safety records, or complaint resolution, and you get the runaround or a hostile response, that’s not a good sign;
• Recent, Frequent Changes in Ownership: While not always negative, this sometimes leads to instability, changes in policy, or cost-cutting measures that affect care;
• A History of “Actual Harm” or “Immediate Jeopardy” Deficiencies: These are the most serious types of citations. A facility with a pattern of these is demonstrating a serious inability to protect its residents;
• Difficulty Getting Access to See the Whole Facility: If they only want to show you the freshly renovated wing and seem hesitant for you to see older parts or interact freely, be suspicious.

Your Due Diligence Matters – And So Does Accountability

If you suspect nursing home neglect or abuse has harmed someone you care about, call us. Let’s talk about what happened and how we will help.

Contact personal injury attorneys at Hughey Law Firm today at (843) 881-8644 for a confidential consultation.

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Nathan Hughey

Nathan Hughey, an attorney and fourth-generation South Carolinian, founded Hughey Law Firm in 2007. Before that, he spent five years defending nursing homes and insurance companies. Leveraging his experience, he now advocates for those injured or wronged by such entities, securing over $290 million in verdicts and settlements.