Choosing a nursing home for a parent or loved one has never been as simple as finding the closest facility with an available bed.
That is especially true following the repeal of the federal nursing-home staffing requirements adopted in 2024. Families may understandably wonder whether fewer federal staffing mandates mean they have fewer ways to judge whether a facility is safe.
Fortunately, staffing is only one part of the picture. Families considering nursing homes in Wilmington, Bear, Smyrna, or elsewhere in Delaware can look at inspection history, staff turnover, resident care, facility conditions, and Delaware’s own staffing requirements before making a decision.
Delaware Still Has Its Own Staffing Requirements
The repeal of the federal staffing rule did not eliminate Delaware’s state protections.
Under Delaware law, nursing facilities must maintain staffing adequate to meet residents’ care needs, including residents with dementia, illnesses, injuries, or other special needs. Delaware’s Eagle’s Law also establishes minimum direct-care staffing requirements for skilled nursing facilities.
Those staffing requirements returned to effect on January 1, 2025, after being suspended during fiscal years 2024 and 2025.
Importantly, meeting a numerical minimum does not necessarily mean staffing is adequate for every facility. Delaware law separately requires sufficient nursing staff to meet residents’ actual needs.
Start With Inspection Records
Before scheduling a tour, research the facility.
Delaware’s Division of Health Care Quality inspects nursing homes at least annually and may also conduct complaint investigations, surprise inspections, after-hours visits, and weekend visits.
Families can request or review a facility’s survey history. Look beyond whether a nursing home simply “passed” an inspection.
Consider what inspectors actually found. Repeated problems involving resident supervision, medication, infection control, pressure injuries, falls, or similar issues may deserve closer attention.
Medicare’s Care Compare system can also provide information about health inspections, staffing, and quality measures.
No rating system can tell you everything about a facility, but these records can help identify questions worth asking during a visit.
Look Beyond the Overall Star Rating
A nursing home’s overall rating can be a useful starting point, but it should not be the end of your research.
Look separately at staffing, health inspections, and quality measures.
Staff turnover can be especially informative. Medicare reports nursing staff turnover because employees who remain at a facility longer may become more familiar with residents’ individual needs and the facility’s procedures.
A facility relying heavily on unfamiliar or temporary workers may still provide appropriate care, but families should ask how continuity of care is maintained.
Visit the Facility
A scheduled tour can reveal things that statistics cannot.
Notice whether call bells are going unanswered, residents appear unattended in hallways, or staff seem rushed. Look at cleanliness and whether residents appear appropriately dressed and cared for.
Pay attention to how employees interact with residents. Are they patient and respectful? Do they seem to know residents by name?
Ask who is actually present during evenings, nights, and weekends, and not simply how many employees work at the facility overall.
Delaware requires nursing facilities to post the names and titles of direct caregivers assigned to each floor, unit, or wing for each shift.
Ask Questions Based on Your Loved One’s Needs
A nursing home that works well for one resident may be inappropriate for another.
If your loved one has dementia, ask how the facility handles wandering and elopement risks. If the resident has limited mobility, ask about fall prevention, transfers, repositioning, and pressure-sore prevention.
For someone with complicated medical needs, ask how quickly nurses can reach physicians and how changes in condition are communicated to families.
Other useful questions include how often care plans are updated, how the facility responds after a fall, and how it handles complaints from residents and relatives.
Specific answers are more useful than promises that the facility provides “excellent care.”
Why Legal Guidance Matters
Families can’t prevent every nursing-home injury, but nursing homes remain responsible for providing care consistent with applicable legal and professional requirements.
When a resident suffers a serious injury, Nitsche & Fredricks LLC can help Delaware families investigate what happened and determine whether neglect or another failure in care may have contributed to the injury.
