I agree with TracyB--- I also see Brandys point. I guess working in both LTC and acute care, I have seen both sides.
I have sent resident's to hospitals with fully intact skin and received them back with stage III pressure sores, and significant weight losses. I can also recall several times that I had called report to the receiving hospital and the ER nurse gave me the 'they're old... just let them die... why are you wasting my time?!!" attitude.
I have also sent capable residents to hospitals who suffered an 'acute confusional episode' in the nursing home--- who, before they were confused would consistently refuse to allow nursing care, now that they are confused, they appear at the hospital looking all nice & neglected. I recall one resident who refused a shower for over 90 days. Nothing worked to get this lady into the shower. She was 100% capable, and perfectly with it. Try to force her and in the long term care facilities [due to our wonderful regulations], you are guilty of "Resident Abuse" or assault and battery.
There are some nursing homes out there that are just pig styes. They shouldn't be allowed to take care of house plants, let alone human beings.
I guess I have no good answer to this one, except, try to communicate. Remember, when you take report from a nursing home nurse, that they are not in the same mode of thought as you are... the focus of the nursing care provided in nursing homes is dramatically different from the hospital.
I hope this helps, but something tells me it doesn't.