TEMPERANCE, Mich. (WTOL) - Around 11 on a recent morning, a noodle ball game broke out inside Vibrant Life Senior Living in Temperance, Mich.

As administrator Catie Reese and marketing director Molly DeLucia stood to the side, 14 residents batted around a balloon with pool noodles.

“The resident council told us that they wanted more noodle ball,” DeLucia says.

The competitive, late-morning game may seem like an insignificant activity for an assisted-living facility that is home to 40 seniors – the oldest 95 years old. But Chris Stieben, the director of ABLE’s Long-term Care Ombudsman Program, tells families scouting for a senior facility for their loved ones that enrichment programs are an indicator of a facility doing things right.

“Make sure there is activity. I would be looking for a calendar of activity. Are there things for people to do?” he says.

There are more than 15,600 nursing home facilities in the United States. ABLE monitors 98 homes in its 10-county northwest Ohio coverage area. It can be a daunting challenge for families to find the right facility.

A bad decision can result in dealing with a nightmarish administrator or, worse, putting a family member in danger. In October, a 73-year-old resident with dementia was sexually assaulted by another resident at Eden Springs Nursing and Rehabilitation in Green Springs, Ohio. In January, a resident at an Arizona nursing facility gave birth despite being in a coma for more than a decade. In Ohio, 36 percent of the 919 Ohio facilities rated by the U.S. Center for Medicare and Medicaid Services were deemed to be “below average” or “much below average.” In Michigan, 27 percent of 436 homes fell in the same level.

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“Gut instinct is crucial,” DeLucia says. “You know when you walk in a place when something just doesn’t feel right. It’s crucial to recognize that.”

Based on recommendations from those with experience in selecting quality nursing facilities, there are a number of factors a family should consider:

Cleanliness

“It’s important that a facility smell like home. There are normal smells in your home,” Stieben says. “You walk into my home, you will smell normal smells – something cooking, a cat smell. … You should not smell one particular smell over another, particularly urine or feces."

Location

“Location is the most important thing. No nursing home, no hospital is perfect,” says Stieben, who says proximity is important so problems can quickly be addressed. “They are human beings taking care of human beings. Let’s find the closest home to where you live.”

Staffing

“Staffing ratios are really important. You can ask, but you can also see if the staff looks like their burden is a little bit heavy,” says DeLucia.

During a visit to Toledo’s Ursuline Center, whose residents are limited to vowed catholic religious - meaning sisters and priests, family members of the Ursuline sisters, and associates of the Ursuline sisters - Sister Ann McManus, 79, and Sister Margaret Anne Carstensen, 88, raved about the quality of the staff.

“They do everything well here. You couldn’t ask for a nicer place to be. It’s a beautiful place to be,” McManus says. “They take care of you. We get fed well. We don’t have to worry about anything.”

Entertainment

At Vibrant Life and the Ursuline Center, calendars of events were visible and the residents talked enthusiastically about the entertainment options available, including guest musicians, libraries, games, art classes, and exercise programs.

“Enrichment is crucial. You want to know your loved one will be happy and well cared for, and life enrichment is part of that,” says DeLucia.

Sister Sandy Sherman, the general superior/president of Ursuline Sisters, has been involved with seniors her entire life, including as a high school student, when she worked in a nursing home. She says a robust activities schedule is something families should look for in a successful facility.

“You don’t want to find a bunch of people sitting around, not doing anything, or just sitting in front of the TV,” she says.

Safety

“This is a safe place,” says Bill Shinaver, 80, who is a retired Toledo policeman and current resident of Vibrant Living. “All the doors are wired. They will go ‘ding, ding, ding’ and four people will come running.”

There are numerous resources for families to use to compare facilities and to find recent inspection reports, violations, staffing levels, contacts, and other information. Medicare.gov, CMS.gov, and, in Ohio, ltc.ohio.gov should be reviewed to see if a facility has the care needed for your loved one or for warning signs. Stieben says ABLE has an extensive profile, including complaints, on area nursing facilities. Information can be obtained by calling ABLE at (419) 259-2891. A volunteer force of 34, empowered by law to meet with residents and administrators, compiles the list of complaints for ABLE and works with the facility to make changes.

DeLucia encourages families to visit different homes and even stay over night if that is possible, which it is at Vibrant Living.

“Look at other communities. Just because you have fallen in love with one community doesn’t mean you shouldn’t look at others,” she says.

According to Stieben, research has never been more important because dwindling staffs are making issues more pronounced.

“There aren’t a lot of people going into the field. It doesn’t have a lot of prestige. It is hard work to take care of folks … and the pay is not high,” Stieben says. “As quantity dwindles, the quality does too.”

The office of ABLE’s Longterm Care Ombudsman program is located on Jefferson Avenue in downtown Toledo. It can be reached by calling (419) 259-2891.