7 steps to choose a care facility for your loved one.

The basic steps for a caregiver to choose a care facility for a loved one for whom it is no longer safe/convenient/feasible to live at home are as follows:

1.       Selecting an appropriate facility.

2.       Locating fitting facilities and making contact.

3.       Holing preliminary visits.

4.       Narrowing down your alternatives and conducting interviews.

5.       Reading the fine print.

6.       Asking for licensing reports.

7.       Contacting the long-term care ombudsman.

Steps for choosing a care facility

Selecting an appropriate facility

·         Independent living facilities often include amenities (entertainment, meals, and socialization). Some provide light housekeeping or transportation services, and a few have staff to administer medication and coordinate healthcare.

·         Adult residential care includes licensed boarding homes that offer room and board, help with medications, and personal care. Residents receive limited supervision.

·         Adult family homes are licensed to care for up to 6 residents and may accommodate couples. They offer room, board, laundry, assistance with activities of daily living, personal care, and social services.

·         Assisted living facilities place emphasis on privacy, independence, and personal choice. Most provide meals, personal care, medication assistance, limited supervision, organized activities, and/or limited nursing services.

·         Continuing care retirement communities admit still independent seniors, and provide professional nursing care and other services as needed.

·         Nursing homes offer rooms, meals, recreation, personal care, 24-hour nursing care, and protective supervision. Services provided by nursing homes should be licensed and comply with state and federal regulations.

Locating fitting facilities and making contact

·         Ask friends and relatives for recommendations.

·         Doctors, social workers, and clergy members may make referrals.

·         Ask the care receiver if he/she has friends with residential care experience who could offer input.

·         Once you have a list of potential alternatives, make a first round of phone calls.

·         Ask basic questions regarding vacancies, number of residents, costs and method of payment, and participation in Medicare and Medicaid.

·         Consider transportation, meals, housekeeping, recreation, special Alzheimer’s units, medication policies, and other services.

Holding preliminary visits

·         Bring your loved one.

·         Look for the facility’s license or ask to see it.

·         Inspect the building and grounds.

·         Speak to some of the residents.

·         Speak to the administrator or the person in charge of everyday operations.

·         Speak to the staff.

·         Speak with other residents’ relatives.

·         Ask to be shown a copy of the admission agreement or contract.

Narrowing down  your alternatives and conducting interviews

·         Go back to the facilities that appear to be capable of meeting your loved one’s needs.

·         Speak further with the staff and residents.

·         If possible, visit the facility unannounced.

·         Request to arrange an overnight stay for your relative before deciding.

Reading the fine print

·         Discuss the contract with a lawyer.

·         The care receiver can change the terms of the contract prompted by him/herself and a facility representative.

·         Make sure the contract is correct before the care receiver signs it.

·         The contract should specify your loved one’s rights and obligations – including the facility’s grievance procedures –, how much money your relative must pay daily or monthly, the cost of items not included in the basic daily/monthly fee, the facility’s policy on holding a bed if the care receiver leaves temporarily, and whether the facility is certified by Medicaid or Medicare.

Requesting licensing reports

·         Review the most recent survey or inspection.

·         Make sure any deficiencies the facility may have had have been fixed.

·         If an assisted living facility is connected to a nursing home, ask to be shown the nursing home’s inspection report and examine the administrative structure.

·         Think twice about facilities that fail to produce these documents.

Contacting the long-term care ombudsman

·         Ombudsmen monitor complaints about quality of care, and problems that residents have concerning eligibility for state programs, financial status, legal difficulties, and transfer assistance.

·         The ombudsman program can provide a breakdown of residents’ rights and federal and state regulations.


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