“Old times never come back and I suppose it’s just as well.  What comes back is a new morning every day in the year, and that’s better.”

– George Edward Woodberry


I’m not sure why it is, but time has really been flying by for me lately.  It seems like before I know it, I look up and the day, week, and month are gone.  It probably isn’t just me, I’ll bet.

Well, last weekend was spent at the Frontiers of Flight Museum in Dallas with my oldest daughter (and later my second) waiting for her history fair project to be judged at the regional competition.  She didn’t place, but she and her project partner got to hang out with her friends, and I got to look at a bunch of airplanes and a space module.  I’ve never been there before and it is really a neat museum.  And if you like that sort of thing, the Cavanaugh Flight Museum near Addison airport is also a ton of fun.

Since the Olympics have been on, I’ve tried to make sure we watch a little bit with the girls.  They don’t go much for watching sports generally, but I’m trying to make sure they see some sports that they may not have known existed (curling?).  Who knows what will spark there interest.

One thing I really enjoy are the stories that go with the Olympics – from the drama between Apollo Ohno and the South Koreans, to the hockey upset in the game between the US and Canada, to the Canadian figure skater that recently lost her mom and skated anyway and did fantastic.  The dedication and drive that these athletes have is phenomenal.

I ran across this about the American skier Lindsey Vonn.  She’s known as perhaps the world’s top female skier having dominated the World Cup the last couple years–but she entered these Olympics with a serious shin injury which left many to wonder if she could even compete.  Take a look at the video of her run and the sheer explosion of joy when she saw her time.  It is awesome.  Watch it here: http://bit.ly/bQAVvC

This week I’d like to talk about something a little different.  For far too many people, the “story” of their lives doesn’t end as well as they might have hoped. Care facilities (when they’re necessary) can be a blessing…or they can be a nightmare. So, to help you make sure that your family (and your friends’ families) make the best decision possible, I’ve put together a two-part series on nursing home placement–and how to do it right.

Feel free to forward this along to anyone who may be affected by these issues. We’re always here to help!

Aaron Miller’s

“Straight Talk” Personal Strategy

Making Nursing Home Placements That Work (Part 1)

It’s a fact: most nursing home admissions happen under extremely stressful circumstances.

It’s an overwhelming task, to find the best nursing home placement for a loved one, perhaps because, where do you even begin?

But, although this is a job that no one wants, it can be done with forethought and confidence that the best decision was made for everyone involved. It’s easier (and better for your loved one), if that first placement is well thought out. Yes–a nursing home resident can be moved from one facility to another, but this type of disruption is rarely in everyone’s best interest as it can be disturbing on a variety of levels.

So it’s best to do it right–from the beginning.

Here’s a great place to start your search:

The Federal Center for Medicare & Medicaid Services (CMS) has a part of its Web site called “Nursing Home Compare”.  Surprisingly, for a government service, it’s actually quite handy:


This area identifies facilities that have a history of poor performance–and ones which do well. In fact, the Nursing Home Compare site labels nursing homes it calls “Special Focus Facilities” — those that have repeatedly violated state and federal health and safety rules and that rank in the worst 5 to 10 percent of all inspected facilities in a given state.

You’ll want to cross those off your list from the very beginning.

Using this website, you can see detailed inspection information about each nursing facility that interests you, comparing various government-rated “quality measures” such as:

• Percent of High-Risk Residents Who Have Pressure Sores

• Percent of Residents Who Spend Most of Their Time in Bed or in a Chair

• Percent of Residents Who Have Moderate to Severe Pain

• Percent of Residents Who Were Physically Restrained

Et cetera.

The site also rates the care and services that each facility provides to its residents, and allows you to view how each facility stacks up in staffing hours for each type of health care worker against the state and national averages.

And there’s other comparison tools available. For example, U.S. News and World Report has recently started providing rankings of America’s nursing homes.


These rankings rely on the data from the above, government site–but they DO provide some advanced search engine capability. Nursing homes are presented in tiers within each star category, based on their total stars in all three of the major areas. The topmost tier, for example, consists only of five-star homes that got 15 stars. The next tier down is five-star homes with 14 total stars, and so on.

Within each tier, nursing homes are listed alphabetically. If you’re looking for a nursing home by location, and turn up too many, search terms can be combined in order to narrow the results.  For example, perhaps you want to search just for nursing homes that have a religious affiliation, or that accept Medicaid residents. Or you can launch a multipronged search, perhaps searching for non-profit four-star nursing homes that accept Medicaid and are located within 25 miles of a particular city.

Placing your loved one in a nursing home that accepts Medicaid is vitally important if you plan to use the services of a law firm to help you with Medicaid Asset Protection.

However–here’s my big caveat when it comes to just looking at ratings: Nothing can substitute for visiting a nursing home in person. After all, every nursing home will have some deficiencies; working with extremely disabled and impaired persons is very difficult.

So, to find the best possible nursing home for your family’s situation, the first step is to determine what is most important for your family in looking for a facility. And I hope that you would agree that the potential resident’s needs and desires must be included in this evaluation. Consider variables such as location of the facility, whether a special care unit (such as for dementia) is available, and what types of payment sources are accepted.

The second step is to identify the facilities in your area which meet the criteria you have established.

In my next Note, I’ll give you some pointers on how to conduct an onsite tour properly–what to look for, questions to ask, etc.

And, of course, we’re here to help. Give us a call if we can serve you in any way!

To your family’s wealth, health, and happiness!

Aaron Miller

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